Organization
MARTINSBURG INTERNAL MEDICINE ASSOC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JESSE BRIAN JALAZO MD (PRESIDENT)
(304) 263-0913
Entity
Organization
Contact information
Practice address
1002 SUSHRUTA DR, MARTINSBURG, WV 25401-8897
(304) 263-0913
(304) 267-2917
Mailing address
1002 SUSHRUTA DR, MARTINSBURG, WV 25401-8897
(304) 263-0913
(304) 267-2917
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0008030000
—
WV
Enumeration date
04/03/2006
Last updated
08/22/2020
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