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Organization
MID-OHIO VALLEY MEDICAL GROUP, INC
Active
Organization
MID-OHIO VALLEY MEDICAL GROUP, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LISA G HAYS (OFFICE COORDINATOR)
(304) 485-4439
Entity
Organization
Contact information
Practice address
800 GRAND CENTRAL MALL, SUITE 4, VIENNA, WV 26105-4131
(304) 485-3300
(304) 485-6489
Mailing address
800 GRAND CENTRAL MALL, SUITE 4, VIENNA, WV 26105-4131
(304) 485-3300
(304) 485-3317
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01387
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2160325
—
OH
05
—
4000315000
—
WV
Enumeration date
04/07/2006
Last updated
12/13/2011
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