Individual
DR. CLEMENTE CAMPOS DIAZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
75 AVENUE B, RICHWOOD, WV 26261-1236
(304) 846-2573
(304) 846-9562
Mailing address
75 AVENUE B, RICHWOOD, WV 26261-1236
(304) 846-2573
(304) 846-9562
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
09181
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0127946000
—
WV
Enumeration date
08/22/2005
Last updated
07/09/2009
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