| NPI | 1902654726 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUSTIN GIBSON VP, Finance 304-598-4256 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine Pulmonary Disease |
| Additional Taxonomies | 207Y00000X Otolaryngology |
| 208000000X Pediatrics | |
| 2084N0400X Psychiatry & Neurology Neurology | |
| 363A00000X Physician Assistant | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2024-05-07 |
| Last Update Date | 2025-04-08 |