Organization
WEST VIRGINIA DERMATOLOGY AND SKIN SURGERY CENTER
Active
Other names
West Virginia Dermatology
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID W JUDY D.O. (OWNER)
(304) 925-7546
Entity
Organization
Contact information
Practice address
4202 MACCORKLE AVE SW STE 200, SOUTH CHARLESTON, WV 25309-1513
(304) 925-7546
(681) 205-8369
Mailing address
4202 MACCORKLE AVE SW STE 200, SOUTH CHARLESTON, WV 25309-1513
(304) 925-7546
(681) 205-8369
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
2596
WV
Other
Enumeration date
04/30/2012
Last updated
01/06/2020
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