Individual
MARY TERESA LEGENZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1400 HAL GREER BLVD, HUNTINGTON, WV 25701-4114
(304) 399-6556
(304) 399-6554
Mailing address
1400 HAL GREER BLVD, HUNTINGTON, WV 25701-4114
(304) 399-6556
(304) 399-6554
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
25804
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000213230
BLUE SHIELD
KY
05
—
64271133
—
KY
Enumeration date
12/14/2005
Last updated
12/06/2021
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