Organization
MEDICAL PARK ANESTHESIOLOGISTS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN E DUDICH MD (PRESIDENT)
(304) 233-2455
Entity
Organization
Contact information
Practice address
1 MEDICAL PARK, WHEELING, WV 26003-6379
(304) 233-2455
(304) 233-6073
Mailing address
PO BOX 6732, WHEELING, WV 26003-0656
(304) 233-2455
(304) 233-6073
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0006511000
—
WV
05
—
0359375
—
OH
Enumeration date
05/01/2007
Last updated
12/05/2013
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