# WVU MED CORP (MDGRP)

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1467667030
- **Authorized official:** TERRY D MILLER (PROVIDER RELATIONS ANALYST)
- **Authorized official phone:** (304) 293-5033

## Contact information

- **Practice address:** 255 SCOTT AVE, MORGANTOWN, WV 26508-8803
- **Practice address phone:** (304) 293-5033
- **Practice address fax:** (304) 293-6963
- **Mailing address:** P O BOX 780, MORGANTOWN, WV 26507-0780
- **Mailing address phone:** (304) 293-5033
- **Mailing address fax:** (309) 293-6963

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 0011526000 | WV | Yes |

## Other

- **Enumeration date:** 05/14/2007
- **Last updated:** 08/22/2020