| NPI | 1275748477 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRY D MILLER Provider Relations Analyst 304-293-5033 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WV 0007384000) |
| Enumeration Date | 2007-05-11 |
| Last Update Date | 2020-08-22 |