# WVUPC-KANAWHA VALLEY FAMILY PRACTICE

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

## Provider details

- **NPI number:** 1114170693
- **Legal business name:** WEST VIRGINIA UNIVERSITY MEDICAL CORPORATION
- **Authorized official:** ROBYN M MCDANIEL (PROVIDER RELATIONS SUPERVISOR)
- **Authorized official phone:** (304) 293-5033

## Contact information

- **Practice address:** 401 DIVISION ST, SUITE 205, S CHARLESTON, WV 25309-1455
- **Practice address phone:** (304) 768-3941
- **Mailing address:** PO BOX 7000, MORGANTOWN, WV 26507-7000
- **Mailing address phone:** (304) 293-7401
- **Mailing address fax:** (304) 293-6963

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 10/29/2008
- **Last updated:** 10/29/2008