| NPI | 1578305256 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK G BOUCOT President/CEO 304-597-3510 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 207P00000X Emergency Medicine |
| Enumeration Date | 2024-06-12 |
| Last Update Date | 2024-06-12 |