Individual
JOSEPH J DEPETRO III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
69 8TH ST, WELLSBURG, WV 26070-1605
(304) 737-0321
(304) 737-2979
Mailing address
PO BOX 6691, WHEELING, WV 26003-0913
(304) 233-2455
(304) 233-6073
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
17078
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0054009000
—
WV
05
—
0970678
—
OH
Enumeration date
01/12/2007
Last updated
07/08/2007
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