Individual
ISMAEL ORTEGO JAMORA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2520 VALLEY DR, SUITE # 116, PT PLEASANT, WV 25550-2031
(304) 675-5188
(304) 675-3811
Mailing address
PO BOX 236, PT PLEASANT, WV 25550-0236
(304) 675-5188
(304) 675-5893
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
10222
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000504
BCBS
WV
05
—
0076037000
—
WV
05
—
0222664
—
OH
01
—
550737600
COMMERICAL INSURANCE
WV
Enumeration date
09/21/2006
Last updated
12/10/2009
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