| NPI | 1477887495 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBYN M MCDANIEL Provider Relations Supervisor 304-293-5033 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology |
| Additional Taxonomies | 207T00000X Neurological Surgery |
| 2080P0202X Pediatrics, Pediatric Cardiology | |
| Enumeration Date | 2009-09-23 |
| Last Update Date | 2009-09-23 |