Individual
MICAH GERASIMOVICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
150 MEMORIAL DR, KINGWOOD, WV 26537-1141
(304) 329-1400
Mailing address
150 MEMORIAL DR, KINGWOOD, WV 26537-1141
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
112680
WV
Other
Enumeration date
06/06/2026
Last updated
06/06/2026
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