Individual
DR. DAVID VELOSO LARDIZABAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
415 MORRIS ST STE 300, CHARLESTON, WV 25301-1853
(304) 388-6441
(304) 388-6445
Mailing address
415 MORRIS ST STE 300, CHARLESTON, WV 25301-1853
(304) 388-6441
(304) 388-6445
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
2004032533
MO
2084N0400X
Neurology Physician
Primary
32510
WV
2084N0400X
Neurology Physician
4301084834
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
207331000
—
MO
Enumeration date
09/22/2005
Last updated
08/30/2023
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