Individual
JORGE ANDRES VALDIVIESO TENEMAZA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1130 14TH ST APT 228A, HUNTINGTON, WV 25701-4061
(859) 536-0915
Mailing address
1130 14TH ST APT 228A, HUNTINGTON, WV 25701-4061
(859) 536-0915
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
08/11/2025
Last updated
08/11/2025
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