| NPI | 1043068521 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUSTIN GIBSON VP, Finance 304-598-4256 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207RI0200X Internal Medicine, Infectious Disease |
| Enumeration Date | 2024-05-09 |
| Last Update Date | 2024-05-09 |