Organization
ORTHOPEDICS-SUNCREST PLAZA
Active
Other names
WVU MEDICAL CORPORATION DBA UHA
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREA M RUMBLE (PROVIDER ENROLLMENT)
(304) 385-7101
Entity
Organization
Contact information
Practice address
1075 VAN VOORHIS RD, MORGANTOWN, WV 26505-3586
(304) 598-4830
(304) 598-4537
Mailing address
PO BOX 897, MORGANTOWN, WV 26507-0897
(304) 285-7100
(304) 285-7126
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
—
—
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0011526000
—
WV
Enumeration date
10/17/2013
Last updated
10/22/2013
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