Individual
JAMES EDWARD SEVERINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DIETITIAN
Contact information
Practice address
812 GORMAN AVENUE, ELKINS, WV 26241
(304) 636-3300
Mailing address
812 GORMAN AVENUE, ELKINS, WV 26241
(304) 636-3300
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
53
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00398765
RAILROAD MEDICARE
WV
Enumeration date
08/07/2006
Last updated
01/14/2008
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