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Individual

ROMEO R EDNACOT

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
207 MAPLEWOOD AVE, RONCEVERTE, WV 24970-1335
(304) 645-7007
(304) 645-7008
Mailing address
PO BOX 3705, CHARLESTON, WV 25337-3705
(304) 536-5030
(304) 536-5031

Taxonomy

Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
10073
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0112064000
WV
Enumeration date
06/10/2005
Last updated
07/09/2007
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