Organization
SOUTH CHARLESTON CARDIODIAGNOSTICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KAREN WAZIR RN (OFFICE MANAGER)
(304) 766-3688
Entity
Organization
Contact information
Practice address
428 DIVISION ST, 1ST FLOOR, SOUTH CHARLESTON, WV 25309-1469
(304) 766-9617
(304) 766-9626
Mailing address
428 DIVISION ST, 1ST FLOOR, SOUTH CHARLESTON, WV 25309-1469
(304) 766-9617
(304) 766-9626
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0010978000
—
WV
01
—
5272533
AETNA
WV
Enumeration date
04/10/2007
Last updated
08/22/2020
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