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Organization
HEALTH AND EDUCATION BUILDING
Active
Organization
HEALTH AND EDUCATION BUILDING
Active
Parent organization
WEST VIRGINIA UNIVERSITY MEDICAL CORPORATION
Organization subpart
Yes
Provider details
NPI number
Legal business name
WEST VIRGINIA UNIVERSITY MEDICAL CORPORATION
Authorized official
ANDREA RUMBLE (PROVIDER ENROLLMENT SPECIALIST)
(304) 285-7101
Entity
Organization
Contact information
Practice address
390 BIRCH STREET, MORGANTOWN, WV 26506-6894
(304) 285-7200
Mailing address
PO BOX 780, MORGANTOWN, WV 26507-0780
(304) 285-7100
(304) 285-7126
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
NULL
207Q00000X
Family Medicine Physician
—
—
2083P0901X
Public Health & General Preventive Medicine Physician
—
NULL
2083P0901X
Public Health & General Preventive Medicine Physician
—
—
2083X0100X
Occupational Medicine Physician
—
NULL
2083X0100X
Occupational Medicine Physician
—
—
2085R0202X
Diagnostic Radiology Physician
—
NULL
2085R0202X
Diagnostic Radiology Physician
—
—
261QS1000X
Student Health Clinic/Center
Primary
—
NULL
Other
Enumeration date
08/24/2011
Last updated
05/22/2014
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