NPI | 1982720801 |
---|---|
Other Name | MSMR |
Entity Type | Organization |
Authorized Contact | DOSHIA K PETRY WARD Practice Manager 304-400-4900 |
Organization Subpart ? | No |
Primary Taxonomy | 207R00000X Internal Medicine |
Additional Taxonomies | 174400000X Specialist (Licence: WV 1818) |
174400000X Specialist (Licence: WV 1767) | |
207RR0500X Internal Medicine, Rheumatology | |
363L00000X Nurse Practitioner | |
363LF0000X Nurse Practitioner, Family | |
Enumeration Date | 2007-03-22 |
Last Update Date | 2025-03-27 |