Organization
PROACTIVE MD WV CORPORATION
Active
Other names
Union Health and Wellness Center, Proactive MD
Organization subpart
No
Provider details
NPI number
Authorized official
MARK KEMBLE MD (CMO)
(864) 501-0754
Entity
Organization
Contact information
Practice address
269 STAUNTON AVENUE SW, SUITE 100, S. CHARLESTON, WV 25303
(304) 768-0321
(864) 990-3834
Mailing address
124 ALLAWOOD CT, SIMPSONVILLE, SC 29681-6207
(864) 501-0754
(864) 990-3834
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
07/03/2024
Last updated
04/03/2025
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