# MEDICAL ASSOCIATES OF GLEN DANIELS, PLLC

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

## Provider details

- **NPI number:** 1730216557
- **Authorized official:** J JORGE GORDINHO MD (OWNER)
- **Authorized official phone:** (304) 934-5125

## Contact information

- **Practice address:** 264 COAL RIVER RD, GLEN DANIEL, WV 25844-9402
- **Practice address phone:** (304) 934-5125
- **Practice address fax:** (304) 934-6967
- **Mailing address:** PO BOX 216, GLEN DANIEL, WV 25844
- **Mailing address phone:** (304) 934-5125
- **Mailing address fax:** (304) 934-6967

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 16005 | WV | Yes |

## Other

- **Enumeration date:** 02/28/2007
- **Last updated:** 06/05/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 3810003365 | — | WV |