Organization
STONEWALL JACKSON MEMORIAL HOSPITAL
Active
Other names
Mountaineer Healthcare for Women
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID D SHAFFER (ADMINISTRATOR)
(304) 269-8000
Entity
Organization
Contact information
Practice address
66 HOSPITAL PLZ, SUITE 103, WESTON, WV 26452-8552
(304) 269-3108
(304) 269-3109
Mailing address
230 HOSPITAL PLZ, WESTON, WV 26452-8558
(304) 269-8000
(304) 269-8090
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
20690
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0001417002
—
WV
Enumeration date
06/19/2008
Last updated
06/26/2008
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