| Mountain State Diabetes | |
|
1900 Garfield Ave Ste A Parkersburg WV 26101-2565 | |
| (877) 377-8427 | |
| (304) 699-0396 |
| Full Name | Mountain State Diabetes |
|---|---|
| Speciality | Internal Medicine |
| Location | 1900 Garfield Ave Ste A, Parkersburg, West Virginia |
| Authorized Official Name and Position | David Neal Pickering (OWNER) |
| Authorized Official Contact | 8773778427 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mountain State Diabetes 1900 Garfield Ave Ste A Parkersburg WV 26101-2565 Ph: (877) 377-8427 | Mountain State Diabetes 1900 Garfield Ave Ste A Parkersburg WV 26101-2565 Ph: (877) 377-8427 |
| NPI Number | 1548892532 |
|---|---|
| Provider Enumeration Date | 02/07/2020 |
| Last Update Date | 11/30/2021 |
| Medicare PECOS PAC ID | 4183053150 |
|---|---|
| Medicare Enrollment ID | O20200327000087 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548892532 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RE0101X | Internal Medicine - Endocrinology, Diabetes & Metabolism | (* (Not Available)) | Primary |
| Provider Name | David N Pickering |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1932412442 PECOS PAC ID: 4880863810 Enrollment ID: I20110809000498 |
| Provider Name | Dana R Cruse |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932482874 PECOS PAC ID: 9032348131 Enrollment ID: I20140213000885 |
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