Provider Demographics
NPI:1790857167
Name:DUREMDES, GENE B (MD)
Entity Type:Individual
Prefix:
First Name:GENE
Middle Name:B
Last Name:DUREMDES
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 1:201 12TH STREET EXT
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:WV
Mailing Address - Zip Code:24740-2329
Mailing Address - Country:US
Mailing Address - Phone:304-425-1852
Mailing Address - Fax:304-431-3756
Practice Address - Street 1:100 NEW HOPE RD STE 106
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:WV
Practice Address - Zip Code:24740-2143
Practice Address - Country:US
Practice Address - Phone:304-425-5093
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2023-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101232178208600000X
WV16015208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA7335061Medicaid
WV0125385000Medicaid
WVF56024Medicare UPIN
VA7335061Medicaid