| NPI | 1598513079 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUSTIN GIBSON VP, Finance 304-598-4256 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology |
| Additional Taxonomies | 176B00000X Midwife |
| 363LF0000X Nurse Practitioner Family | |
| 363LP0200X Nurse Practitioner Pediatrics | |
| Enumeration Date | 2024-05-09 |
| Last Update Date | 2024-05-09 |