Individual
DR. MARY H.L. MCJUNKIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1120 KANAWHA BLVD E, CHARLESTON, WV 25301-2400
(304) 344-3457
(304) 344-3480
Mailing address
PO BOX 11137, CHARLESTON, WV 25339-1137
(304) 344-3457
(304) 344-3480
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
15204
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0119999000
—
WV
01
—
0130753
UMWA
WA
05
—
0828153
—
OH
05
—
14175
—
WV
01
—
14193
CARELINK & CARELINK PEIA
WV
05
—
64697014
—
KY
01
—
B99029
BRICKSTREET INSURANCE
WV
Enumeration date
06/10/2005
Last updated
02/26/2008
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