| NPI | 1083149405 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY S WARD Credentialing Coordinator 304-234-8663 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology |
| 207X00000X Orthopaedic Surgery | |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| 208VP0000X Pain Medicine, Pain Medicine | |
| 207Q00000X Family Medicine | |
| 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism | |
| 207RG0100X Internal Medicine, Gastroenterology | |
| 207RH0003X Internal Medicine, Hematology & Oncology | |
| 207RI0200X Internal Medicine, Infectious Disease | |
| Enumeration Date | 2017-04-23 |
| Last Update Date | 2017-11-29 |