Individual
JANELLE MARIE KING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
800 GRAND CENTRAL MALL, SUITE 3, VIENNA, WV 26105-4100
(304) 865-0555
(304) 865-0556
Mailing address
125 N 6TH ST, CLARKSBURG, WV 26301-2665
(304) 624-7200
(304) 865-0556
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
25241
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810026009
—
WV
Enumeration date
05/22/2009
Last updated
01/23/2015
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