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Organization

WEST VIRGINIA UNIVERSITY MEDICAL CORPORATION

Active
Parent organization
WEST VIRGINIA UNIVERSITY MEDICAL CORPORATION
Organization subpart
Yes

Provider details

NPI number
Legal business name
WEST VIRGINIA UNIVERSITY MEDICAL CORPORATION
Authorized official
JUSTIN GIBSON (VP, FINANCE)
(304) 598-4256
Entity
Organization

Contact information

Practice address
60 MACLAINE WAY STE A, SHEPHERDSTOWN, WV 25443-1667
(304) 876-6343
(304) 901-7024
Mailing address
PO BOX 780, MORGANTOWN, WV 26507-0780
(304) 285-7101
(304) 293-6963

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
207R00000X
Internal Medicine Physician
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
207RR0500X
Rheumatology Physician
208000000X
Pediatrics Physician
363LF0000X
Family Nurse Practitioner

Other

Enumeration date
05/14/2024
Last updated
05/14/2024
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