Individual
DR. ISIDRO A AMIGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
8 ROSE ST, GRAFTON, WV 26354-1678
(304) 265-0095
(304) 265-6215
Mailing address
PO BOX 42738, TOWSON, MD 21284-2738
(844) 468-9502
(317) 663-6054
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
1181
WV
208600000X
Surgery Physician
34002976
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0128645000
—
WV
05
—
0551675
—
OH
Enumeration date
05/12/2006
Last updated
04/07/2016
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