Organization
UNITED HOSPITAL CENTER
Active
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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