Individual
DONALD P MUNDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PAC
Contact information
Practice address
314 PINE ST, PENDLETON COMMUNITY CARE INC, FRANKLIN, WV 26807-0100
(304) 358-2355
(304) 358-3054
Mailing address
PO BOX 100, FRANKLIN, WV 26807-0100
(304) 358-2355
(304) 358-3054
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
00216
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001714349
MS BCBS
WV
05
—
3810000541
—
WV
Enumeration date
12/07/2005
Last updated
03/17/2014
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