Organization
WVU MED CORP (MDGRP)
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERRY D MILLER (PROVIDER RELATIONS ANALYST)
(304) 293-5033
Entity
Organization
Contact information
Practice address
255 SCOTT AVE, MORGANTOWN, WV 26508-8803
(304) 293-5033
(304) 293-6963
Mailing address
P O BOX 780, MORGANTOWN, WV 26507-0780
(304) 293-5033
(309) 293-6963
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0011526000
WV
Other
Enumeration date
05/14/2007
Last updated
08/22/2020
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