Penny S Divita, DO

NPI #1598744757 in Charleston, West Virginia

Provider Information

NPI Number: 1598744757
Entity Type: Individual
Name: Penny S Divita, DO
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Pediatrics
Credential: DO
Enumeration Date: Jan 16, 2006
Last Updated: Jun 23, 2011

Practice Location

Address: 830 PENNSYLVANIA AVE
Address 2: STE 200
City: Charleston
State: West Virginia
ZIP Code: 25302-3302
Phone: (304) 388-2709

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Emergency Medicine	207P00000X
Pediatrics	208000000X	Primary

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