Individual
STACIE D GUMP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2838 PIKE STREET, WVU MEDICINE PATRIOT POINTE CAMDEN CLARK PHYSICI CORPOR, PARKERSBURG, WV 26101
(304) 865-5070
(304) 489-4250
Mailing address
4 ROSEMAR CIRCLE, PARKERSBURG, WV 26101
(304) 485-6130
(304) 485-1519
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
25319
WV
207Q00000X
Family Medicine Physician
D0060181
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
402740000
—
MD
Enumeration date
08/17/2005
Last updated
04/18/2022
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