Organization
VAIDYA UROLOGY CLINIC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. BRENDA G LONG (OFFICE MANAGER)
(304) 675-6060
Entity
Organization
Contact information
Practice address
2520 VALLEY DRIVE, SUITE 016, POINT PLEASANT, WV 25550
(304) 675-6060
(304) 675-5001
Mailing address
2520 VALLEY DRIVE, SUITE 016, POINT PLEASANT, WV 25550
(304) 675-6060
(304) 675-5001
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
13842
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001707383
MOUNTAIN STATE BCBS
WV
05
—
0131036000
—
WV
05
—
0544987
—
OH
01
—
340018637
TRAVELERS MEDICARE
WV
Enumeration date
11/16/2007
Last updated
06/27/2008
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