| NPI | 1962287722 |
|---|---|
| Doing Business As | CAMC GVMC GPI |
| Entity Type | Organization |
| Authorized Contact | BRYAN LUZADER Provider Enrollment Manager 304-388-0151 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist |
| Additional Taxonomies | 156F00000X Technician/Technologist |
| 207R00000X Internal Medicine | |
| 246X00000X Spec/Tech, Cardiovascular | |
| Enumeration Date | 2023-08-30 |
| Last Update Date | 2023-10-10 |