Organization
CHARLESTON INTERNAL MEDICINE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERRY COLEMAN (PRACTICE ADMINISTRATOR)
(304) 720-2345
Entity
Organization
Contact information
Practice address
3701 MACCORKLE AVE SE, CHARLESTON, WV 25304-1525
(304) 720-2345
(304) 720-2347
Mailing address
3701 MACCORKLE AVE SE, CHARLESTON, WV 25304-1525
(304) 720-2345
(304) 720-2347
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
APRN76968-NP-C
WV
Other
Enumeration date
07/17/2015
Last updated
07/17/2015
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