Individual
DR. CHARLOTTE L DILLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
101 STADIUM DR, MORGANTOWN, WV 26506-7911
(304) 598-4000
(304) 293-6963
Mailing address
PO BOX 897, MORGANTOWN, WV 26507-0897
(304) 293-7401
(304) 293-6963
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
16093
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0118337000
—
WV
01
—
P00687674
RAILROAD MEDICARE
DC
Enumeration date
03/23/2006
Last updated
05/26/2009
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