| NPI | 1265530752 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAYANK S AMIN Owner 304-324-2715 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WV 20921) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WV 19428) |
| 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: WV 20602) | |
| 363LF0000X Nurse Practitioner, Family (Licence: WV 36628) | |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2020-08-22 |