Individual
STEPHEN WANTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1 MEDICAL CENTER DR, ROOM 4601, MORGANTOWN, WV 26506-1200
(304) 293-1254
(304) 293-4711
Mailing address
PO BOX 9238, MORGANTOWN, WV 26506-9238
(304) 293-1254
(304) 293-4711
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/10/2015
Last updated
02/04/2022
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