| Diabetes, Endocrinology & Lipidology Center, Inc. | |
|
176 Health Care Ln Suite B Martinsburg WV 25401-4010 | |
| (304) 260-1060 | |
| (304) 260-1062 |
| Full Name | Diabetes, Endocrinology & Lipidology Center, Inc. |
|---|---|
| Speciality | Internal Medicine |
| Location | 176 Health Care Ln, Martinsburg, West Virginia |
| Authorized Official Name and Position | Philip Joseph Ryan (PRESIDENT) |
| Authorized Official Contact | 3042601060 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Diabetes, Endocrinology & Lipidology Center, Inc. 176 Health Care Ln Suite B Martinsburg WV 25401-4010 Ph: (304) 260-1060 | Diabetes, Endocrinology & Lipidology Center, Inc. 176 Health Care Ln Suite B Martinsburg WV 25401-4010 Ph: (304) 260-1060 |
| NPI Number | 1275810830 |
|---|---|
| Provider Enumeration Date | 11/10/2011 |
| Last Update Date | 02/07/2012 |
| Medicare PECOS PAC ID | 9739354226 |
|---|---|
| Medicare Enrollment ID | O20111212000700 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275810830 | NPI | - | NPPES |
| 3810022262 | Medicaid | WV |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RE0101X | Internal Medicine - Endocrinology, Diabetes & Metabolism | 21393 (West Virginia) | Primary |
| Provider Name | Philip J Ryan |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1043396229 PECOS PAC ID: 2264325471 Enrollment ID: I20040203000410 |
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