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Individual

DR. JULIE K. MCCAMMON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D

Contact information

Practice address
527 MEDICAL PARK DR, SUITE 104, BRIDGEPORT, WV 26330-9007
(304) 933-3868
(304) 933-3870
Mailing address
527 MEDICAL PARK DR, SUITE 104, BRIDGEPORT, WV 26330-9007
(304) 933-3868
(304) 933-3870

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
WV1559
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
001710806
MOUNTAIN STATE BC/BS
WV
05
0091494000
WV
01
DO6136
RAILROAD MEDICARE
WV
01
WV1559
THE HEALTH PLAN
WV
Enumeration date
02/04/2009
Last updated
01/13/2015
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