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Organization

NEW CENTURY EMERGENCY PHYSICIAN OF WEST VIRGINIA INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
WILLIAM A COLE JR. MD (CEO)
(800) 726-3627
Entity
Organization

Contact information

Practice address
501 MORRIS ST, CHARLESTON, WV 25301-1326
(304) 388-7498
Mailing address
4750 HEMPSTEAD STATION DR, KETTERING, OH 45429-5164
(800) 875-0136

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
WV
363A00000X
Physician Assistant
WV
363L00000X
Nurse Practitioner
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
001709239
WV BCBS (MD DO)
WV
01
001709240
WV BCBS (NP)
WV
01
001769857
WV BCBS (PA)
WV
05
0203138000
WV
01
150778000
FECA
WV
05
3048973
OH
Enumeration date
12/21/2005
Last updated
09/15/2010
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