Organization
WEIRTON MEDICAL CENTER INC
Active
Parent organization
WEIRTON MEDICAL CENTER INC
Other names
Keith Bravo, MD
Organization subpart
Yes
Provider details
NPI number
Legal business name
WEIRTON MEDICAL CENTER INC
Authorized official
KEITH BRAVO MD (STAFF)
(304) 723-4328
Entity
Organization
Contact information
Practice address
651 COLLIERS WAY, SUITE 502, WEIRTON, WV 26062-5053
(304) 723-4328
Mailing address
PO BOX 2581, WEIRTON, WV 26062-1781
(304) 723-6040
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
19983
WV
208000000X
Pediatrics Physician
Primary
19983
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0001352005
—
WV
05
—
2147582
—
OH
05
—
6000332000
—
WV
05
—
9298808
—
OH
Enumeration date
06/12/2007
Last updated
12/31/2007
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