| NPI | 1881839892 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEREK KAZNOSKI Owner / Physician 304-263-9332 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: WV 23323) |
| Additional Taxonomies | 2080A0000X Pediatrics, Adolescent Medicine (Licence: WV 2357) |
| Enumeration Date | 2008-12-04 |
| Last Update Date | 2008-12-04 |