| NPI | 1265221196 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GROVER GLENDON KERNS VP Of Finance 304-260-1443 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2025-05-06 |
| Last Update Date | 2025-05-06 |