Organization
FAIRMONT PHYSICIANS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JULIANNE SHROYER (BILLING MGR)
(304) 367-0043
Entity
Organization
Contact information
Practice address
211 MARION SQ, FAIRMONT, WV 26554-1367
(304) 367-0043
Mailing address
PO BOX 2990, 211 MARION SQUARE, FAIRMONT, WV 26555-2990
(304) 367-0043
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0009022007
—
WV
Enumeration date
11/26/2007
Last updated
11/26/2007
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