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Organization

PLEASANT VALLEY EMERGENCY PHYSICIANS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ROBIN A PAYNE (CREDENTIALLING SPECIALIST)
(304) 675-4340
Entity
Organization

Contact information

Practice address
2520 VALLEY DR, PT PLEASANT, WV 25550
(304) 675-4340
(304) 675-1328
Mailing address
2520 VALLEY DR, PT PLEASANT, WV 25550-2031
(304) 675-4340
(304) 675-1328

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
1102
WV
207P00000X
Emergency Medicine Physician
1441
WV
207P00000X
Emergency Medicine Physician
18261
WV
207P00000X
Emergency Medicine Physician
905
WV
207P00000X
Emergency Medicine Physician
945
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0009656000
WV
01
001710511
BCBS
WV
05
0164227
OH
Enumeration date
09/21/2006
Last updated
05/14/2018
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