Organization
BARBOURSVILLE INTERNAL MEDICINE & PEDIATRICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MATTHEW WAYNE HARRIS M.D. (PRESIDENT)
(304) 736-4000
Entity
Organization
Contact information
Practice address
4 CHATEAU LN, BARBOURSVILLE, WV 25504-1626
(304) 736-4000
(304) 736-5690
Mailing address
4 CHATEAU LN, BARBOURSVILLE, WV 25504-1626
(304) 736-4000
(304) 736-5690
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
208000000X
Pediatrics Physician
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0201059000
—
WV
05
—
2204877
—
OH
Enumeration date
08/25/2005
Last updated
10/29/2014
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