NPI | 1154429041 |
---|---|
Entity Type | Organization |
Authorized Contact | JOSEPH MATUSIC Physician 304-343-1863 |
Organization Subpart ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: WV 731) |
Additional Taxonomies | 208000000X Pediatrics (Licence: WV 1451) |
208000000X Pediatrics (Licence: WV 15140) | |
208000000X Pediatrics (Licence: WV 18217) | |
208000000X Pediatrics (Licence: WV 16381) | |
291U00000X Clinical Medical Laboratory (Licence: WV 51D0910134) | |
363L00000X Nurse Practitioner (Licence: WV 18804) | |
Enumeration Date | 2006-09-21 |
Last Update Date | 2011-06-23 |