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Organization
MARIETTA MEMORIAL HOSPITAL
Active
Organization
MARIETTA MEMORIAL HOSPITAL
Active
Other names
Physicians Group for WVDHS
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL G WESTBROCK (CCO)
(740) 374-1581
Entity
Organization
Contact information
Practice address
401 MATTHEW ST, PROVIDER ENROLLMENT, MARIETTA, OH 45750-1635
(740) 374-1400
Mailing address
401 MATTHEW ST, MARIETTA, OH 45750-1635
(740) 374-1400
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
—
—
207P00000X
Emergency Medicine Physician
—
—
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
208600000X
Surgery Physician
—
—
213E00000X
Podiatrist
—
—
282N00000X
General Acute Care Hospital
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0001529002
—
WV
Enumeration date
01/20/2015
Last updated
03/24/2022
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