Individual
DR. OPHELIA DIAZ CANSINO
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
800 GARFIELD AVE, PARKERSBURG, WV 26101-5340
(304) 424-2590
(304) 422-3924
Mailing address
3211 DUDLEY AVE, PARKERSBURG, WV 26104-1813
(304) 422-3904
(304) 422-9324
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
10733
WV
207L00000X
Anesthesiology Physician
35056317
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0059103000
—
WV
05
—
0365608
—
OH
Enumeration date
09/27/2005
Last updated
07/08/2007
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