Organization
DR L E SYNER AND DR W M WINE ASSOC IN ORAL & MAXILLOFACIAL SURG INC,
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. PAT SHUMATE (OFFICE MANAGER)
(304) 252-8609
Entity
Organization
Contact information
Practice address
750 STANAFORD RD, BECKLEY, WV 25801-8737
(304) 252-8609
(304) 253-8870
Mailing address
750 STANAFORD RD, BECKLEY, WV 25801-8737
(304) 252-8609
(304) 253-8870
Taxonomy
Speciality
Code
Description
License number
State
261QS0112X
Oral and Maxillofacial Surgery Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0138270000
—
WV
05
—
0138303000
—
WV
Enumeration date
10/02/2006
Last updated
01/19/2010
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