Organization
CHARLESTON AREA MEDICAL CENTER, INC.
Active
Other names
CAMC Pediatric & Adult ENT
Organization subpart
No
Provider details
NPI number
Authorized official
BRYAN LUZADER (PROVIDER ENROLLMENT MANAGER)
(304) 388-0151
Entity
Organization
Contact information
Practice address
1311 VIRGINIA ST E STE 100, CHARLESTON, WV 25301-3011
(304) 353-0210
Mailing address
400 ASSOCIATION DR STE 102, CHARLESTON, WV 25311-1298
(304) 388-1724
(304) 388-1721
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
—
—
Other
Enumeration date
09/26/2023
Last updated
09/26/2023
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