Organization
PARKERSBURG MEDICAL ASSOCIATES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PAUL GREGORY MODIE M.D. (PRESIDENT)
(304) 485-5531
Entity
Organization
Contact information
Practice address
1122 MARKET ST, PARKERSBURG, WV 26101-4321
(304) 485-5531
(304) 485-9596
Mailing address
1122 MARKET ST, PARKERSBURG, WV 26101-4321
(304) 485-5531
(304) 485-9596
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
9171
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0008734000
—
WV
05
—
0416740
—
OH
Enumeration date
04/25/2007
Last updated
08/22/2020
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