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Organization
MAIN STREET MEDICAL PLLC
Active
Organization
MAIN STREET MEDICAL PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT B WALKER M.D. (PRESIDENT)
(304) 733-6484
Entity
Organization
Contact information
Practice address
650 MAIN ST, BARBOURSVILLE, WV 25504-1439
(304) 733-6484
(304) 733-6486
Mailing address
650 MAIN ST, BARBOURSVILLE, WV 25504-1439
(304) 733-6484
(304) 733-6486
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
10652
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0056287000
—
WV
Enumeration date
12/23/2009
Last updated
12/23/2009
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