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Organization
CHARLESTON MEDICAL CENTER, INC.
Active
Organization
CHARLESTON MEDICAL CENTER, INC.
Active
Other names
CAMC PMC Specialty Clinics, Vandalia Health Multi-Specialty Office
Organization subpart
No
Provider details
NPI number
Authorized official
GINGER PETERS (PAYER ENROLLMENT REPRESENTATIVE)
(304) 388-0112
Entity
Organization
Contact information
Practice address
211 W MAPLE AVE, FAYETTEVILLE, WV 25840-1445
(304) 900-5511
Mailing address
211 W MAPLE AVE, FAYETTEVILLE, WV 25840-1413
(304) 900-5511
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
—
—
208600000X
Surgery Physician
—
—
231H00000X
Audiologist
—
—
282N00000X
General Acute Care Hospital
Primary
—
—
Other
Enumeration date
03/09/2026
Last updated
09/11/2026
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