Individual
CHARLES WESLEY CLEMENTS II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1600 MEDICAL CENTER DR, SUITE 1500, HUNTINGTON, WV 25701-3656
(304) 691-1100
(304) 691-1183
Mailing address
1600 MEDICAL CENTER DR, SUITE 1500, HUNTINGTON, WV 25701-3656
(304) 691-1100
(304) 691-1183
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
19611
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2157259
—
OH
05
—
5630273000
—
WV
05
—
64010614
—
KY
Enumeration date
03/29/2006
Last updated
11/24/2021
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