Organization
MID-OHIO VALLEY MEDICAL GROUP INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LISA G HAYS (OFFICE COORDINATOR)
(304) 485-4439
Entity
Organization
Contact information
Practice address
610 WASHINGTON BLVD, SUITE 1, BELPRE, OH 45714-2465
(740) 423-5055
(740) 423-5058
Mailing address
800 GRAND CENTRAL MALL, SUITE 4, VIENNA, WV 26105-4100
(304) 485-4439
(304) 485-6489
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
1514286
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2751991
—
OH
05
—
3810008457
—
WV
01
—
DF3852
RAILROAD MEDICARE PIN
OH
Enumeration date
04/12/2007
Last updated
06/05/2013
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