| Penny S Divita, DO | |
|
830 Pennsylvania Ave, Ste 200, Charleston, WV 25302-3302 | |
| (304) 388-2709 | |
| Not Available |
| Full Name | Penny S Divita |
|---|---|
| Gender | Female |
| Speciality | Pediatrics |
| Location | 830 Pennsylvania Ave, Charleston, West Virginia |
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598744757 | NPI | - | NPPES |
| 001718046 | Other | WV | BLUE CROSS BLUE SHIELD |
| 0046618000 | Medicaid | WV | |
| 1040493 | Other | WV | DWC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207P00000X | Emergency Medicine | 1461 (West Virginia) | Secondary |
| 208000000X | Pediatrics | 1451 (West Virginia) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Penny S Divita, DO 830 Pennsylvania Ave, Ste 200, Charleston, WV 25302-3302 Ph: (304) 388-2709 | Penny S Divita, DO 830 Pennsylvania Ave, Ste 200, Charleston, WV 25302-3302 Ph: (304) 388-2709 |
Dr. John M Eckerd, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 830 Pennsylvania Ave, Suite 103, Charleston, WV 25302 Phone: 304-388-1552 Fax: 304-388-1577 | |
Jennifer Anne Hines, D.O. Pediatrics Medicare: Medicare Enrolled Practice Location: 100 Florida St, Charleston, WV 25302 Phone: 304-414-4015 Fax: 304-414-4018 | |
Jane Elizabeth Nicholas, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 800 Pennsylvania Ave, Charleston, WV 25302 Phone: 304-414-1880 Fax: 304-414-1886 | |
Afif S Habash, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 4920 Maccorkle Ave Se, Charleston, WV 25304 Phone: 304-442-8117 | |
Mrs. Mary C Pozega, D.O. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 5324 Maccorkle Ave Se, Charleston, WV 25304 Phone: 304-925-7001 Fax: 304-925-7234 | |
Youmna Mousattat, MD Pediatrics Medicare: Accepting Medicare Assignments Practice Location: 800 Pennsylvania Ave, Charleston, WV 25302 Phone: 304-388-2525 | |
Dr. Stefan Randolph Maxwell, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 830 Pennsylvania Ave, Suite 406, Charleston, WV 25302 Phone: 304-388-2238 Fax: 304-388-2243 |