Vaman Shripad Diwan, MD

Individual provider Active NPI Surgery Physician · Pineville, WV

NPI 1255400511 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1255400511
Entity type
Individual (NPI type 1)
Primary specialty
Surgery Physician 208600000X
License
10880 (WV)
Practice address
335 Williamson Ave
Pineville, WV 24874-1470
Phone
(304) 732-6155
NPI assigned
Nov 8, 2006
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 10880 WV Yes

Addresses

Primary practice location

335 Williamson Ave
Pineville, WV 24874-1470

Mailing address

335 Williamson Ave
PO Box 1470
Pineville, WV 24874-1470
Phone (304) 732-6155

Other identifiers

IdentifierTypeStateIssuer
0083525000MedicaidWV

Other providers in Pineville, WV

All providers in Pineville, WV · Surgery Physician in West Virginia

Sources for this page

Verify at the official NPI Registry.