| NPI | 1447576491 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHELIA JANE PORTER Billing Manager 304-296-2395 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WV 19609) |
| Enumeration Date | 2010-04-15 |
| Last Update Date | 2010-04-15 |