Individual
DR. AMY LEE WIRTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4602 MACCORKLE AVE SE, CHARLESTON, WV 25304-1848
(304) 925-4777
(304) 925-4870
Mailing address
1606 KANAWHA BLVD W, SUITE 304, CHARLESTON, WV 25387-2536
(304) 388-7782
(304) 388-7788
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
19420
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810000467
—
WV
01
—
P00206389
RAILROAD MEDICARE
—
Enumeration date
04/13/2006
Last updated
01/28/2016
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