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Organization
FOOTWISE PODIATRY OF W.VA. INC.
Active
Organization
FOOTWISE PODIATRY OF W.VA. INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GORDON A MILLER D.P.M. (PRESIDENT PHYSICIAN)
(304) 599-9000
Entity
Organization
Contact information
Practice address
1191 PINEVIEW DR STE H1, MORGANTOWN, WV 26505-0480
(304) 599-9000
(304) 599-4091
Mailing address
1191 PINEVIEW DR STE H1, MORGANTOWN, WV 26505-0480
(304) 599-9000
(304) 599-4091
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
193400000X
WV
213EP1101X
Primary Podiatric Medicine Podiatrist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0008547000
—
WV
01
—
001709829
BLUE CROSS
WV
Enumeration date
12/19/2006
Last updated
05/12/2022
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