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Individual

DR. DARLENE Y. GRUETTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
3200 MACCORKLE AVENUE SE, PATHOLOGY DEPARTMENT, CHARLESTON, WV 25304
(304) 388-5550
(304) 388-4352
Mailing address
1400 HOSPITAL DR, HURRICANE, WV 25526-9202
(304) 757-1770
(304) 757-1736

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
16894
WV
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
16894
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0102729000
WV
05
64700537
KY
Enumeration date
05/27/2005
Last updated
12/23/2015
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