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Individual

CHRISTINA B GILLENWATER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
273 SKIDMORE LN, SUTTON, WV 26601-9272
(304) 765-4400
(304) 765-0354
Mailing address
273 SKIDMORE LANE, SUTTON, WV 26601
(304) 765-4400
(304) 765-0354

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
25672
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1770876021
WV
05
3810027479
WV
Enumeration date
05/19/2011
Last updated
08/24/2022
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