# GRAND CENTRAL FAMILY MEDICINE, P.L.L.C.

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

## Provider details

- **NPI number:** 1891756029
- **Authorized official:** DAVID W AVERY M.D. (OWNER)
- **Authorized official phone:** (304) 422-3400

## Contact information

- **Practice address:** 418 GRAND PK DR, SUITE 312, PARKERSBURG, WV 26101-0000
- **Practice address phone:** (304) 422-3400
- **Practice address fax:** (304) 422-7893
- **Mailing address:** 418 GRAND PK DR, SUITE 312, PARKERSBURG, WV 26101-0000
- **Mailing address phone:** (304) 422-3400
- **Mailing address fax:** (304) 422-7893

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 363LF0000X | Family Nurse Practitioner | — | NULL | — |
| 363LF0000X | Family Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 03/29/2006
- **Last updated:** 10/12/2007