| NPI | 1639376650 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY SUE WARD Credentialing Coordinator 304-234-8663 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 1114) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 1114) |
| 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: OH 1114) | |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: OH 1114) | |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: OH 1114) | |
| 207RI0200X Internal Medicine, Infectious Disease (Licence: OH 1114) | |
| 207V00000X Obstetrics & Gynecology (Licence: OH 1114) | |
| 207X00000X Orthopaedic Surgery (Licence: OH 1114) | |
| 207ZH0000X Pathology, Hematology (Licence: OH 1114) | |
| 2083X0100X Preventive Medicine, Occupational Medicine (Licence: OH 1114) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OH 1114) | |
| 208600000X Surgery (Licence: OH 1114) | |
| 208D00000X General Practice (Licence: OH 1114) | |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: OH 1114) | |
| 207L00000X Anesthesiology (Licence: OH 1114) | |
| Enumeration Date | 2007-07-02 |
| Last Update Date | 2016-01-11 |