Individual
JOHN EFFAT BACILIOUS DIKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1600 MEDICAL CENTER DRIVE, HUNTINGTON, WV 25701-3656
(304) 691-8850
(304) 523-9470
Mailing address
1448 10TH AVENUE, SUITE 304, HUNTINGTON, WV 25701-3579
(304) 691-6381
(304) 691-8591
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
33351
WV
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/06/2018
Last updated
06/25/2024
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