Organization
ULYSSES D AGAS M D INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ULYSSES D AGAS MD (OWNER)
(304) 752-3434
Entity
Organization
Contact information
Practice address
557 MAIN STREET, LOGAN, WV 25601
(304) 752-3435
(304) 752-3436
Mailing address
PO BOX 210, LOGAN, WV 25601-0210
(304) 752-3435
(304) 752-3436
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
WV13227
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001720467
BLUE CROSS BLUE SHIELD
WV
05
—
3810012113
—
WV
Enumeration date
10/24/2007
Last updated
11/21/2012
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