Individual
DR. STEPHANUS JOHANNES SERFONTEIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2418 JEFFERSON AVE, PT PLEASANT, WV 25550-1528
(304) 675-6835
(304) 675-6849
Mailing address
3200 MACCORKLE SEAVE B16, CHARLESTON, WV 25304-1227
(304) 388-5848
(304) 388-9654
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
21778
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2548390
—
OH
05
—
3810001774
—
WV
Enumeration date
09/21/2006
Last updated
12/22/2015
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