Basic Information
| Provider Information | |||||||||
| NPI: | 1649362708 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PIZARRO | ||||||||
| FirstName: | EVANGELINE | ||||||||
| MiddleName: | CARANDANG | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | CARANDANG | ||||||||
| OtherFirstName: | EVANGELINE | ||||||||
| OtherMiddleName: | REYES | ||||||||
| OtherNamePrefix: | DR. | ||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | M.D. | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 2115 CHAPLINE ST | ||||||||
| Address2: | SUITE 201 | ||||||||
| City: | WHEELING | ||||||||
| State: | WV | ||||||||
| PostalCode: | 260033859 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3042341610 | ||||||||
| FaxNumber: | 3042341739 | ||||||||
| Practice Location | |||||||||
| Address1: | 2115 CHAPLINE ST | ||||||||
| Address2: | SUITE 201 | ||||||||
| City: | WHEELING | ||||||||
| State: | WV | ||||||||
| PostalCode: | 260033859 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3042341610 | ||||||||
| FaxNumber: | 3042341739 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/28/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| AuthorizedOfficialFirstName: | |||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | |||||||||
| AuthorizedOfficialTelephone: | |||||||||
| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 11438 | WV | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.