Individual
AMY MOYERS BRENWALT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
UNIVERSITY TOWN CENTRE - SLEETH FAMILY MEDICINE, 6040 UNIVERSITY TOWN CENTRE DR, MORGANTOWN, WV 26501-2421
(855) 988-2273
(304) 285-7372
Mailing address
6040 UNIVERSITY TOWN CENTRE DR, MORGANTOWN, WV 26501-2421
(304) 598-6900
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
26746
WV
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0234573
—
OH
05
—
103398958
—
PA
05
—
1236571
—
MD
05
—
1366852261
—
WV
Enumeration date
04/30/2014
Last updated
03/03/2023
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