| NPI | 1205160645 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBYN M MCDANIEL Provider Relations Supervisor 304-293-5033 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease |
| Enumeration Date | 2009-10-01 |
| Last Update Date | 2009-10-01 |