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Individual

DR. DAVID C. MENDOZA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
604 ANN ST, PARKERSBURG, WV 26101-5122
(304) 865-5155
(304) 865-5156
Mailing address
600 18TH ST, SUITE 303, PARKERSBURG, WV 26101-3231
(304) 424-4593
(304) 424-4017

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
18562
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00361091
RAILROAD MEDICARE
OH
01
00368861
RAILROAD MEDICARE
WV
01
005292138
AETNA
WV
01
00891585
BLUE CROS BLUE SHIELD
WV
05
0130407000
WV
05
0276339
OH
Enumeration date
06/13/2006
Last updated
01/13/2021
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