Individual
MAXWELL JAMES DIERKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
800 PENNSYLVANIA AVE, CHARLESTON, WV 25302-3351
(304) 388-2427
Mailing address
800 PENNSYLVANIA AVE, CHARLESTON, WV 25302-3351
(304) 388-2427
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/02/2025
Last updated
04/02/2025
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