| Parkersburg Infectious Disease Pllc | |
|
800 Grand Central Mall Ste 10 Vienna WV 26105-4100 | |
| (304) 916-1288 | |
| (304) 916-1289 |
| Full Name | Parkersburg Infectious Disease Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 800 Grand Central Mall Ste 10, Vienna, West Virginia |
| Authorized Official Name and Position | Seyoum D Bage (PHYSICIAN) |
| Authorized Official Contact | 3049161288 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Parkersburg Infectious Disease Pllc 800 Grand Central Mall Ste 10 Vienna WV 26105-4100 Ph: (304) 916-1288 | Parkersburg Infectious Disease Pllc 800 Grand Central Mall Ste 10 Vienna WV 26105-4100 Ph: (304) 916-1288 |
| NPI Number | 1427516129 |
|---|---|
| Provider Enumeration Date | 03/12/2019 |
| Last Update Date | 03/12/2019 |
| Medicare PECOS PAC ID | 0446593032 |
|---|---|
| Medicare Enrollment ID | O20190522003166 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427516129 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RI0200X | Internal Medicine - Infectious Disease | (* (Not Available)) | Primary |
| Provider Name | Seyoum Daffo Bage |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1609842640 PECOS PAC ID: 1153399514 Enrollment ID: I20040922001285 |
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