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Organization
WEST VIRGINIA UNIVERSITY MEDICAL CORPORATION
Active
Organization
WEST VIRGINIA UNIVERSITY MEDICAL CORPORATION
Active
Parent organization
WEST VIRGINIA UNIVERSITY MEDICAL CORPORATION
Organization subpart
Yes
Provider details
NPI number
Legal business name
WEST VIRGINIA UNIVERSITY MEDICAL CORPORATION
Authorized official
JUSTIN GIBSON (VP, FINANCE)
(304) 598-4256
Entity
Organization
Contact information
Practice address
430 CERITOS TRL, MARTINSBURG, WV 25403-0400
(304) 267-6249
Mailing address
PO BOX 780, MORGANTOWN, WV 26507-0780
(304) 285-7101
(304) 293-6963
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
363A00000X
Physician Assistant
—
NULL
363A00000X
Physician Assistant
—
—
363LF0000X
Family Nurse Practitioner
—
NULL
363LF0000X
Family Nurse Practitioner
—
—
Other
Enumeration date
05/09/2024
Last updated
05/09/2024
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