# WEST VIRGINIA UNIVERSITY MEDICAL CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** WEST VIRGINIA UNIVERSITY MEDICAL CORPORATION
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1063380525
- **Legal business name:** WEST VIRGINIA UNIVERSITY MEDICAL CORPORATION
- **Authorized official:** JUSTIN GIBSON (VP OF FINANCE)
- **Authorized official phone:** (304) 598-4256

## Contact information

- **Practice address:** 390 BIRCH ST, MORGANTOWN, WV 26505-9042
- **Practice address phone:** (304) 598-4214
- **Mailing address:** PO BOX 780, MORGANTOWN, WV 26507-0780

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YP2500X | Professional Counselor | — | NULL | Yes |
| 101YP2500X | Professional Counselor | — | — | Yes |
| 104100000X | Social Worker | — | NULL | — |
| 104100000X | Social Worker | — | — | — |
| 2084F0202X | Forensic Psychiatry Physician | — | NULL | — |
| 2084F0202X | Forensic Psychiatry Physician | — | — | — |
| 363A00000X | Physician Assistant | — | NULL | — |
| 363A00000X | Physician Assistant | — | — | — |
| 363LF0000X | Family Nurse Practitioner | — | NULL | — |
| 363LF0000X | Family Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 10/27/2025
- **Last updated:** 10/27/2025