Individual
SAMANTHA WITHROW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
3200 MACCORKLE AVE SE, CHARLESTON, WV 25304-1227
(304) 388-9323
Mailing address
259 SUNDOWN RDG, SOUTH CHARLESTON, WV 25309-1731
(304) 951-9733
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
105809
WV
Other
Enumeration date
05/19/2020
Last updated
05/19/2020
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