Individual
WIGBERTO C CAMOMOT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
329 MAIN STREET, RED JACKET, WV 25692-0329
(304) 426-6428
(304) 426-8413
Mailing address
PO BOX 329, RED JACKET, WV 25692-0329
(304) 426-6428
(304) 426-8413
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
13624
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0050600000
—
WV
Enumeration date
10/02/2006
Last updated
03/19/2008
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