| NPI | 1588610570 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN JURJUS AZAR Owner 304-366-0111 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology |
| Additional Taxonomies | 291U00000X Clinical Medical Laboratory (Licence: WV 17192) |
| 332900000X Non-Pharmacy Dispensing Site (Licence: WV 26308) | |
| Enumeration Date | 2006-05-25 |
| Last Update Date | 2016-11-16 |