Organization
UNITED HOSPITAL CENTER
Active
Other names
UHC Professional Group
Organization subpart
No
Provider details
NPI number
Authorized official
RUSSELL JOHN PLYWACZYNSKI (VP FINANCE)
(681) 342-1000
Entity
Organization
Contact information
Practice address
327 MEDICAL PARK DRIVE, BRIDGEPORT, WV 26330
(681) 342-3100
(681) 342-3125
Mailing address
PO BOX 775, MORGANTOWN, WV 26507-0775
(681) 342-1000
(681) 342-3125
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
WV107
WV
207R00000X
Internal Medicine Physician
Primary
WV107
WV
207RC0000X
Cardiovascular Disease Physician
WV107
WV
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
WV107
WV
2086S0129X
Vascular Surgery Physician
WV107
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0001276003
MEDICAID PROVIDER NUMBER
WV
01
—
5100061
MEDICARE PTAN
WV
01
—
C30572
RR GROUP NUMBER
WV
01
—
CD9216
RR GROUP NUMBER
WV
01
—
CD9217
RR GROUP NUMBER
WV
01
—
CD9712
RR GROUP NUMBER
—
01
—
CI9203
RR GROUP NUMBER
—
Enumeration date
03/02/2007
Last updated
09/12/2025
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