| NPI | 1932077922 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUSTIN GIBSON VP Of Finance 304-598-4256 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207ZC0006X Pathology, Clinical Pathology |
| Additional Taxonomies | 207RI0200X Internal Medicine, Infectious Disease |
| 363LF0000X Nurse Practitioner, Family | |
| 207ZP0101X Pathology, Anatomic Pathology | |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology | |
| 2086S0129X | |
| Enumeration Date | 2025-10-29 |
| Last Update Date | 2025-10-29 |