Provider Demographics
NPI:1538237193
Name:GARCIA, DIOSDADO A (MD)
Entity type:Individual
Prefix:MR
First Name:DIOSDADO
Middle Name:A
Last Name:GARCIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 MARKET ST
Mailing Address - Street 2:SUITE 1000
Mailing Address - City:STEUBENVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43952-2881
Mailing Address - Country:US
Mailing Address - Phone:740-284-1775
Mailing Address - Fax:740-284-1749
Practice Address - Street 1:401 MARKET ST
Practice Address - Street 2:SUITE 1100
Practice Address - City:STEUBENVILLE
Practice Address - State:OH
Practice Address - Zip Code:43952-2881
Practice Address - Country:US
Practice Address - Phone:740-282-1624
Practice Address - Fax:740-282-1679
Is Sole Proprietor?:No
Enumeration Date:2006-12-01
Last Update Date:2009-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD031183L207R00000X, 207RC0200X
OH35041328207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0084609000Medicaid
OH0253470Medicaid
OH0934443Medicare PIN
PA099101PK7Medicare PIN
C01466Medicare UPIN