Organization
UNITED HOSPITAL CENTER
Active
Other names
UHC Gastroenterology
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL TILLMAN (CEO)
(681) 342-1620
Entity
Organization
Contact information
Practice address
527 MEDICAL PARK DR STE 402, BRIDGEPORT, WV 26330-9010
(681) 342-3690
Mailing address
527 MEDICAL PARK DR STE 402, BRIDGEPORT, WV 26330-9010
(681) 342-3690
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
107
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810021342
—
WV
Enumeration date
04/15/2010
Last updated
11/05/2015
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