Individual
DR. MARTIN J KOMMOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3200 MACCORKLE AVE SE, 5TH FLOOR BAHAVIORAL MEDICINE, CHARLESTON, WV 25304-1227
(304) 347-1300
(304) 347-1397
Mailing address
3200 MACCORKLE AVE SE, 5TH FLOOR BAHAVIORAL MEDICINE, CHARLESTON, WV 25304-1227
(304) 347-1300
(304) 347-1397
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
10616
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0116226000
—
WV
Enumeration date
09/20/2006
Last updated
10/03/2013
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