Individual
WARREN DOUGLAS REYNOLDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
415 MORRIS ST, SUITE 201, CHARLESTON, WV 25301-1842
(304) 388-7700
(304) 388-7755
Mailing address
3100 MACCORKLE SEAVE 900, CHARLESTON, WV 25304-1223
(304) 388-3580
(304) 388-3585
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
880
WV
363AS0400X
Surgical Physician Assistant
Primary
457
WV
Other
Enumeration date
12/03/2008
Last updated
12/21/2015
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