| Appalachian Family Medicine | |
|
104 Station Place Way Hurricane WV 25526-8747 | |
| (304) 757-7788 | |
| (304) 201-1140 |
| Full Name | Appalachian Family Medicine |
|---|---|
| Speciality | Family Medicine |
| Location | 104 Station Place Way, Hurricane, West Virginia |
| Authorized Official Name and Position | Sean C. Di Cristofaro (PRESIDENT) |
| Authorized Official Contact | 3047577788 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Appalachian Family Medicine 104 Station Place Way Hurricane WV 25526-8747 Ph: (304) 757-7788 | Appalachian Family Medicine 104 Station Place Way Hurricane WV 25526-8747 Ph: (304) 757-7788 |
| NPI Number | 1063663896 |
|---|---|
| Provider Enumeration Date | 10/10/2008 |
| Last Update Date | 10/10/2008 |
| Medicare PECOS PAC ID | 8325109168 |
|---|---|
| Medicare Enrollment ID | O20081211000390 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063663896 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | DP00454495 (West Virginia) | Secondary |
| 207Q00000X | Family Medicine | 19679 (West Virginia) | Primary |
| Provider Name | Sean Charles Dicristofaro |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1053370056 PECOS PAC ID: 9234030438 Enrollment ID: I20040120000610 |
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