Pediatric Associate in Bridgeport - Legal Medicine
Pediatric Associate - NPI 1104937416
Pediatric Associate is a Legal Medicine in Bridgeport, . Pediatric Associate practices all healthcare services and medical treatments related to Legal Medicine. The NPI Number for Pediatric Associate is 1104937416. The last update date is 2020-08-22.
Pediatric Associate's current location address is 11 Chenoweth Dr, Bridgeport, . You can contact this provider via phone number 3048425777 and fax number 3048423318. The mailing address for Pediatric Associate is 11 Chenoweth Dr, Bridgeport, . To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Pediatric Associate |
|---|---|
| Address | 11 Chenoweth Dr, Bridgeport, |
| Phone Number | 3048425777 |
| Fax Number | 3048423318 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | OWNER |
|---|---|
| Authorized Official Name | Momen Joseph |
| Credentials | M.D. |
| Telephone Number | 3048425777 |
NPI Number Detail
| NPI Number | 1104937416 |
|---|---|
| Provider Enumeration Date | 2006-08-31 |
| Last Updated Date | 2020-08-22 |
Provider Mailing Address Detail
| Address | 11 Chenoweth Dr |
|---|---|
| City | Bridgeport |
| State | (WV) |
| Post Code | 263301675 |
| Phone Number | 3048425777 |
| Fax Number | 3048423318 |
Provider's Primary Taxonomy Detail
| Speciality | Legal Medicine |
|---|---|
| Taxonomy | 173000000X |
| Licence No | WV11941 |
|
Definition: The specialty areas of medicine concerned with matters of, and relations with, substantive law and legal institutions; such as the conduct of medical examinations at crime scenes, performance of autopsies, giving of expert medical testimony in judici |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 10556000 | WV | -- |
Post Comment/ Review Below
What is the Pediatric Associate's unique identification number?
The Pediatric Associate has been assigned the NPI (National Provider Identifier) Number 1104937416 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for the organization.
Could you share the physical location details of Pediatric Associate?
The Pediatric Associate is situated at 11 Chenoweth Dr, in the city of Bridgeport, state of WV, with the zip code 263301675.
What is Pediatric Associate's area of expertise and its corresponding taxonomy classification?
The Pediatric Associate's field of specialization is Legal Medicine, and it falls under the taxonomy code 173000000X, which categorizes healthcare providers based on their areas of practice.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1104937416 to Pediatric Associate?
The Centers for Medicare & Medicaid Services originally issued the 1104937416 to Pediatric Associate on 2006-08-31.
When was the information pertaining to Pediatric Associate most recently updated or revised?
The details related to Pediatric Associate, including its address, specialty, and other relevant information, were last updated or revised on 2020-08-22.
NPI Number: 1982607784
Address: 54045 Ridge Rd, Yucca Valley, CA