Individual
VINCENT PAUL KOLANKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1000 MON HEALTH MEDICAL PARK DR STE 1201, MORGANTOWN, WV 26505
(304) 599-9400
(304) 599-8917
Mailing address
1428 WESTERN AVE, MORGANTOWN, WV 26505-2137
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
14035
WV
208000000X
Pediatrics Physician
Primary
14035
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110049430
MEDICARE RAILROAD
—
Enumeration date
01/27/2006
Last updated
05/07/2021
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