Individual
GERARDO R PRINCESA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
200 HOSPITAL DR, SPENCER, WV 25276-1050
(304) 927-6844
(304) 927-6259
Mailing address
200 HOSPITAL DR, SPENCER, WV 25276-1050
(304) 927-6844
(304) 927-6259
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
21390
WV
207L00000X
Anesthesiology Physician
Primary
A101856
CA
208VP0000X
Pain Medicine Physician
21390
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3004963000
—
WV
Enumeration date
05/04/2006
Last updated
09/20/2010
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