Individual
DR. STEPHEN LEE DIBLASI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
4315 MACCORKLE AVE SE, CHARLESTON, WV 25304-2503
(304) 926-8080
(304) 926-8083
Mailing address
4315 MACCORKLE AVE SE, CHARLESTON, WV 25304-2503
(304) 926-8080
(304) 926-8083
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
053388
GA
207RC0000X
Cardiovascular Disease Physician
Primary
1803
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
471776680A
—
GA
Enumeration date
10/19/2005
Last updated
12/12/2014
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