| Krzysztof J Kubicki, Md | |
|
111 First Ave Chester WV 26034 | |
| (304) 387-2761 | |
| Not Available |
| Full Name | Krzysztof J Kubicki, Md |
|---|---|
| Speciality | Internal Medicine |
| Location | 111 First Ave, Chester, West Virginia |
| Authorized Official Name and Position | Krzysztof J Kubicki (OWNER) |
| Authorized Official Contact | 3043872761 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Krzysztof J Kubicki, Md Po Box 2407 Weirton WV 26062-1607 Ph: (304) 387-2761 | Krzysztof J Kubicki, Md 111 First Ave Chester WV 26034 Ph: (304) 387-2761 |
| NPI Number | 1750314811 |
|---|---|
| Provider Enumeration Date | 07/09/2006 |
| Last Update Date | 12/21/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750314811 | NPI | - | NPPES |
| 3810006572 | Medicaid | WV |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 17474 (West Virginia) | Primary |
Ishimaru Medical Services Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 507 Carolina Ave, Chester, WV 26034 Phone: 304-224-3583 Fax: 304-459-5050 |