Individual
BENNETT D ORVIK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
25 GARTON PLZ, WESTON, WV 26452-2128
(304) 269-6620
(304) 269-4593
Mailing address
25 GARTON PLZ, WESTON, WV 26452-2128
(304) 269-6620
(304) 269-4593
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
11386
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0055675000
—
WV
Enumeration date
06/22/2005
Last updated
12/18/2015
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