Organization
ISLAND MEDICAL SERVICE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BASIL P PAPADIMITRIOU MD (PRESIDENT)
(304) 232-2100
Entity
Organization
Contact information
Practice address
103 S PENN ST, WHEELING, WV 26003-2075
(304) 232-2100
(304) 232-8272
Mailing address
103 S PENN ST, WHEELING, WV 26003-2075
(304) 232-2100
(304) 232-8272
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
8646
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0055704000
—
WV
05
—
6693636
—
OH
Enumeration date
03/07/2007
Last updated
08/22/2020
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