| NPI | 1518303288 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDA LEE MCKEEN Provider Support And Credentialing 304-797-6404 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 208600000X Surgery |
| 207RC0000X Internal Medicine, Cardiovascular Disease | |
| 207T00000X Neurological Surgery | |
| 207VG0400X Obstetrics & Gynecology, Gynecology | |
| 207X00000X Orthopaedic Surgery | |
| 208000000X Pediatrics | |
| Enumeration Date | 2013-05-21 |
| Last Update Date | 2021-03-18 |