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Individual

GENEROSO D DUREMDES

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
100 NEW HOPE RD STE 106, PRINCETON, WV 24740-2143
(304) 425-5093
(304) 487-3675
Mailing address
PO BOX 1374, PRINCETON, WV 24740-1374
(304) 425-5093
(304) 487-3675

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
0101022907
VA
208600000X
Surgery Physician
Primary
09778
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0127426000
WV
05
7335067
VA
Enumeration date
11/13/2006
Last updated
12/17/2007
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