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Organization

FAIRVIEW HEALTH ASSOCIATES INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JOHN STEPHEN SHANK MD (PRESIDENT)
(304) 872-5090
Entity
Organization

Contact information

Practice address
350 FAIRVIEW HEIGHTS RD, SUMMERSVILLE, WV 26651-1085
(304) 872-5090
(304) 872-0636
Mailing address
PO BOX 1029, SUMMERSVILLE, WV 26651-0139
(304) 872-5090
(304) 872-0636

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0202164000
WV
Enumeration date
10/11/2005
Last updated
03/27/2015
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