| NPI | 1013960632 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIM G BUGIN VP Payor Contracting 304-225-2500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 261QU0200X Clinic/Center Urgent Care |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2012-02-14 |