| NPI | 1265650592 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANNON G SYPOLT Office Manager 304-767-7810 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WV 20430) |
| Enumeration Date | 2007-04-23 |
| Last Update Date | 2007-10-02 |