| NPI | 1356783682 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY ELIZABETH MCKELVEY Physician 681-238-5947 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WV 15767) |
| Enumeration Date | 2013-07-29 |
| Last Update Date | 2013-10-02 |