Organization
A E LANDIS MD PC
Active
Organization
A E LANDIS MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANDREW E LANDIS MD (PRESIDENT)
(304) 255-0459
Entity
Organization
Contact information
Practice address
417 CARRIAGE DR, BECKLEY, WV 25801-2805
(304) 255-0459
(304) 252-3471
Mailing address
417 CARRIAGE DR, BECKLEY, WV 25801-2805
(304) 255-0459
(304) 252-3471
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
11229
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1043284110
—
WV
Enumeration date
08/25/2010
Last updated
01/11/2012
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