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Organization

ANESTHESIA MEDICAL GROUP

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ROBERT L WALKER JR. M.D. (PRESIDENT)
(304) 925-5486
Entity
Organization

Contact information

Practice address
3508 STAUNTON AVE SE, CHARLESTON, WV 25304-1477
(304) 925-5486
(304) 925-8075
Mailing address
3508 STAUNTON AVE SE, CHARLESTON, WV 25304-1477
(304) 925-5486
(304) 925-8075

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0063882001
WV
Enumeration date
07/29/2005
Last updated
07/21/2022
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