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Individual

BRIAN CHRISTOPHER POLICANO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
7 CHENOWETH DR, SUITE A, BRIDGEPORT, WV 26330-1887
(304) 842-5777
(304) 842-3318
Mailing address
PO BOX 763, MORGANTOWN, WV 26507-0763
(800) 541-4009

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
WV21260
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
01720854
BC/BS
WV
05
3004243000
WV
Enumeration date
08/02/2006
Last updated
05/03/2017
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