Individual
DR. JOSE CRUZZAVALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
600 18TH STREET, SUITE 201, PARKERSBURG, WV 26101
(304) 424-4760
(304) 424-4761
Mailing address
600 18TH STREET, SUITE 201, PARKERSBURG, WV 26101
(304) 424-4760
(304) 424-4761
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
15479
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0129506000
—
WV
01
—
020045089
RAILROAD MEDICARE
WV
Enumeration date
10/03/2006
Last updated
10/13/2014
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