# MOUNTAINEER FAMILY MEDICINE, INC.

> 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
- **Organization subpart:** No

## Provider details

- **NPI number:** 1366282725
- **Authorized official:** VICTORIA WARNER (BILLING DIRECTOR)
- **Authorized official phone:** (681) 264-4986

## Contact information

- **Practice address:** 258 HANGING ROCK HWY, LOGAN, WV 25601-5113
- **Practice address phone:** (304) 688-9700
- **Mailing address:** 5240 MACCORKLE AVE SE, CHARLESTON, WV 25304-2122
- **Mailing address phone:** (681) 264-4986

## Taxonomy

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

## Other

- **Enumeration date:** 05/31/2024
- **Last updated:** 05/31/2024