# WEST VIRGINIA UNIVERSITY MEDICAL CORPORATION

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

## Provider details

- **NPI number:** 1487403366
- **Legal business name:** WEST VIRGINIA UNIVERSITY MEDICAL CORPORATION
- **Authorized official:** JUSTIN GIBSON (VP, FINANCE)
- **Authorized official phone:** (304) 598-4256

## Contact information

- **Practice address:** 1075 VAN VOORHIS RD STE 200, MORGANTOWN, WV 26505-3587
- **Practice address phone:** (304) 598-6216
- **Practice address fax:** (304) 598-2602
- **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 |
| --- | --- | --- | --- | --- |
| 104100000X | Social Worker | — | NULL | — |
| 104100000X | Social Worker | — | — | — |
| 2084A0401X | Addiction Medicine (Psychiatry & Neurology) Physician | — | NULL | Yes |
| 2084A0401X | Addiction Medicine (Psychiatry & Neurology) Physician | — | — | Yes |

## Other

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