Organization
WVU SPORTS MEDICINE - UHA
Active
Parent organization
WEST VIRGINIA UNIVERSITY MEDICAL CORPORATION
Organization subpart
Yes
Provider details
NPI number
Legal business name
WEST VIRGINIA UNIVERSITY MEDICAL CORPORATION
Authorized official
ROBYN MCDANIEL (PROVIDER RELATIONS SUPERVISOR)
(304) 293-5033
Entity
Organization
Contact information
Practice address
943 MAPLE DR LOWR LEVEL, MORGANTOWN, WV 26505-2812
(304) 598-4830
Mailing address
PO BOX 780, MORGANTOWN, WV 26507-0780
(304) 293-7401
(304) 293-6963
Taxonomy
Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0011526000
—
WV
Enumeration date
07/14/2009
Last updated
07/14/2009
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