Organization
WVU MED CORP MGP INT MED CLINIC(PAAS)
Active
Organization
WVU MED CORP MGP INT MED CLINIC(PAAS)
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERRY D MILLER (PROVIDER RELATIONS ANALYST)
(304) 293-5033
Entity
Organization
Contact information
Practice address
1 STADIUM DRIVE, MORGANTOWN, WV 26506
(304) 293-5033
(304) 293-6963
Mailing address
PO BOX 897, MORGANTOWN, WV 26507-0897
(304) 293-5033
(304) 293-6963
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0007384000
WV
Other
Enumeration date
05/11/2007
Last updated
08/22/2020
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