Basic Information
| Provider Information | |||||||||
| NPI: | 1629241898 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DENNE | ||||||||
| FirstName: | NICOLAS | ||||||||
| MiddleName: | STEVEN | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 13 PAR LN | ||||||||
| Address2: | |||||||||
| City: | MAIDSVILLE | ||||||||
| State: | WV | ||||||||
| PostalCode: | 265418186 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3043285503 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1 MEDICAL CENTER DR | ||||||||
| Address2: | RUBY MEMORIAL HOSPITAL | ||||||||
| City: | MORGANTOWN | ||||||||
| State: | WV | ||||||||
| PostalCode: | 26506 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3042932436 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/09/2008 | ||||||||
| LastUpdateDate: | 04/08/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/08/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | 24199 | WV | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.