Organization
CARLOS C. JIMENEZ MD PROFESSIONAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CARLOS C JIMENEZ MD (OWNER)
(304) 845-1331
Entity
Organization
Contact information
Practice address
1000 WHEELING AVE, GLEN DALE, WV 26038-1750
(304) 845-1331
(304) 845-9152
Mailing address
1000 WHEELING AVE, GLEN DALE, WV 26038-1750
(304) 845-1331
(304) 845-9152
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
10223
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0076414000
—
WV
Enumeration date
10/09/2007
Last updated
12/11/2013
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