| NPI | 1619725199 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUSTIN GIBSON VP, Finance 304-598-4256 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 207RN0300X Internal Medicine Nephrology |
| 207RR0500X Internal Medicine Rheumatology | |
| 207Y00000X Otolaryngology | |
| 207RE0101X Internal Medicine Endocrinology, Diabetes & Metabolism | |
| 225100000X Physical Therapist | |
| 363A00000X Physician Assistant | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2024-05-09 |
| Last Update Date | 2025-03-25 |