# PREMIER MEDICAL GROUP, INC.

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

## Provider details

- **NPI number:** 1679672505
- **Authorized official:** MRS. CHRISTINE D STURTEVANT (CEO)
- **Authorized official phone:** (304) 808-6081

## Contact information

- **Practice address:** 710 GENESIS BLVD, BRIDGEPORT, WV 26330-9668
- **Practice address phone:** (304) 808-6081
- **Practice address fax:** (304) 423-5032
- **Mailing address:** PO BOX 1610, CLARKSBURG, WV 26302-1610
- **Mailing address phone:** (304) 808-6081
- **Mailing address fax:** (304) 423-5032

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 207R00000X | Internal Medicine Physician | — | NULL | — |
| 207R00000X | Internal Medicine Physician | — | — | — |
| 208000000X | Pediatrics Physician | — | NULL | — |
| 208000000X | Pediatrics Physician | — | — | — |
| 291U00000X | Clinical Medical Laboratory | 51D0898849 | WV | — |

## Other

- **Enumeration date:** 09/21/2006
- **Last updated:** 07/21/2014