# WEST VIRGINIA UNIVERSITY MEDICAL CORPORATION

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1295584167
- **Legal business name:** WEST VIRGINIA UNIVERSITY MEDICAL CORPORATION
- **Authorized official:** JUSTIN GIBSON (VP, FINANCE)
- **Authorized official phone:** (304) 598-4256

## Contact information

- **Practice address:** 60 MACLAINE WAY STE A, SHEPHERDSTOWN, WV 25443-1667
- **Practice address phone:** (304) 876-6343
- **Practice address fax:** (304) 901-7024
- **Mailing address:** PO BOX 780, MORGANTOWN, WV 26507-0780
- **Mailing address phone:** (304) 285-7101
- **Mailing address fax:** (304) 293-6963

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 207R00000X | Internal Medicine Physician | — | NULL | — |
| 207R00000X | Internal Medicine Physician | — | — | — |
| 207RE0101X | Endocrinology, Diabetes & Metabolism Physician | — | NULL | — |
| 207RE0101X | Endocrinology, Diabetes & Metabolism Physician | — | — | — |
| 207RR0500X | Rheumatology Physician | — | NULL | — |
| 207RR0500X | Rheumatology Physician | — | — | — |
| 208000000X | Pediatrics Physician | — | NULL | — |
| 208000000X | Pediatrics Physician | — | — | — |
| 363LF0000X | Family Nurse Practitioner | — | NULL | — |
| 363LF0000X | Family Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 05/14/2024
- **Last updated:** 05/14/2024