Organization
WVUH CHEAT LAKE PHYSICIANS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRUCE BOWMAN MCCLYMONDS (ADMINISTRATOR)
(304) 598-4032
Entity
Organization
Contact information
Practice address
1 MEDICAL CENTER DR, MORGANTOWN, WV 26507-1127
(304) 598-4032
(304) 598-4143
Mailing address
PO BOX 1127, MORGANTOWN, WV 26507-1127
(304) 598-4032
(304) 598-4143
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810001961
—
WV
Enumeration date
02/20/2007
Last updated
08/22/2020
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