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Organization

CRAB ORCHARD MEDICAL ASSOC. INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MARIZA A. LIRIO M.D. (VICE PRESIDENT)
(304) 253-8336
Entity
Organization

Contact information

Practice address
1701 ROBERT C. BYRD DRIVE, CRAB ORCHARD, WV 25827
(304) 253-8336
(304) 253-8337
Mailing address
PO BOX 1602, CRAB ORCHARD, WV 25827-1602
(304) 253-8336
(304) 253-8336

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
12066
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0038505000
WV
Enumeration date
10/24/2007
Last updated
10/24/2007
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