| NPI | 1457605404 |
|---|---|
| Doing Business As | WVU OBSTETRICS & GYNECOLOGY-BRIDGEPORT |
| Entity Type | Organization |
| Authorized Contact | TERRY D MILLER Provider Enrollment Specialist 304-285-7101 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory (Licence: WV 51D2012387) |
| Enumeration Date | 2012-10-30 |
| Last Update Date | 2012-10-30 |