# WEST VIRGINIA UNIVERSITY MEDICAL CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** WEST VIRGINIA UNIVERSITY MEDICAL CORPORATION
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1982498499
- **Legal business name:** WEST VIRGINIA UNIVERSITY MEDICAL CORPORATION
- **Authorized official:** JUSTIN GIBSON (VP OF FINANCE)
- **Authorized official phone:** (304) 598-4256

## Contact information

- **Practice address:** 13 WESTERN MARYLAND PKWY STE 106, HAGERSTOWN, MD 21740-6474
- **Practice address phone:** (240) 513-4591
- **Mailing address:** PO BOX 780, MORGANTOWN, WV 26507-0780

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RI0011X | Interventional Cardiology Physician | — | NULL | — |
| 207RI0011X | Interventional Cardiology Physician | — | — | — |
| 207X00000X | Orthopaedic Surgery Physician | — | NULL | — |
| 207X00000X | Orthopaedic Surgery Physician | — | — | — |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | NULL | Yes |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | — | Yes |
| 363A00000X | Physician Assistant | — | NULL | — |
| 363A00000X | Physician Assistant | — | — | — |
| 363L00000X | Nurse Practitioner | — | NULL | — |
| 363L00000X | Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 04/08/2025
- **Last updated:** 04/08/2025