Individual
DR. ISABELITA T DE MESA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
RT 16 MAIN STREET, WAR, WV 24892-0459
(304) 875-4724
(304) 875-4724
Mailing address
PO BOX 459 RT 16, MAIN STREET, WAR, WV 24892-0459
(304) 875-4724
(304) 875-4724
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
13434
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0049844000
—
WV
Enumeration date
10/18/2006
Last updated
01/26/2012
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