Individual
KRZYSZTOF KUBICKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
111 1ST ST, CHESTER, WV 26034-1001
(304) 387-2761
(304) 387-3704
Mailing address
PO BOX 2768, WEIRTON, WV 26062-1968
(304) 723-6040
(304) 723-6039
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
17474
WV
207R00000X
Internal Medicine Physician
35070327
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0076313000
—
WV
05
—
0941413
—
OH
Enumeration date
10/04/2005
Last updated
12/12/2012
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