Provider Demographics
NPI:1902066798
Name:SIMONE, NADEW SEBRO (MD)
Entity type:Individual
Prefix:
First Name:NADEW
Middle Name:SEBRO
Last Name:SIMONE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:400 ASSOCIATION DR STE 102
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25311-1298
Mailing Address - Country:US
Mailing Address - Phone:304-388-0151
Mailing Address - Fax:304-388-1721
Practice Address - Street 1:3100 MACCORKLE AVE SE STE 101
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25304-1215
Practice Address - Country:US
Practice Address - Phone:304-388-8200
Practice Address - Fax:304-388-7010
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-15
Last Update Date:2023-10-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WV32608207R00000X, 207RC0000X
GA91233207RC0000X
IL036127312208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist