Individual
MR. THOMAS PAUL DADISMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
303 S MAIN ST, PHILIPPI, WV 26416-1240
(304) 457-4233
Mailing address
303 S MAIN ST, PHILIPPI, WV 26416-1240
(304) 457-5207
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
4985
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4985
STATE LICENSE
WV
Enumeration date
05/07/2007
Last updated
07/30/2007
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