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Individual

KEVIN R GARNEAU

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
2500 HOSPTIAL DRIVE, MARTINSBURG, WV 25401
(304) 264-1000
(304) 264-1374
Mailing address
PO BOX 1150, MARTINSBURG, WV 25402-1150
(304) 264-1000
(304) 264-1374

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
328
MT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
328
STATE OF MT PROVIDER LICE
MT
05
4300031
MT
05
4305539
MT
01
945323
BC/BS
MT
Enumeration date
05/20/2006
Last updated
03/07/2023
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