NPI 1063646529

Jennifer Divita, DO

Practitioner Pediatrics Physician Charleston, WV

Practice location

Address: 830 Pennsylvania Ave STE 200, Charleston, WV 25302-3302
Phone: (304) 388-2709
Fax: (304) 344-1755
Mailing address: 830 Pennsylvania Ave STE. 200, Charleston, WV 25302-3302

Registered specialties (2)

Pediatrics Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 208000000X Licence 2474 (WV)

Other Pediatrics providers in West Virginia →

Student in an Organized Health Care Education/Training Program

Student, Health Care Taxonomy 390200000X

Other Student in an Organized Health Care Education/Training Program providers in West Virginia →

Registry record

NPI: 1063646529
Entity type: Individual
Sex (as registered): Female
NPI issued: 12 May 2009
Record last updated: 19 Feb 2013

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.