Individual
MR. ROMULO GANUELAS DELA ROSA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
26 MAIN STREET, IAEGER, WV 24844
(304) 938-2955
(304) 938-2955
Mailing address
PO BOX 7, PRINCETON, WV 24740-0007
(304) 938-2955
(304) 938-2955
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
14275
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14275
LIC WV
WV
05
—
5615330
—
WV
Enumeration date
09/01/2006
Last updated
03/07/2023
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