Organization
SUNCREST TOWN CENTRE-WVU
Active
Organization
SUNCREST TOWN CENTRE-WVU
Active
Parent organization
WEST VIRGINIA UNIVERSITY MEDICAL CORPORATION
Organization subpart
Yes
Provider details
NPI number
Legal business name
WEST VIRGINIA UNIVERSITY MEDICAL CORPORATION
Authorized official
ROBYN M MCDANIEL (PROVIDER RELATIONS SUPERVISOR)
(304) 293-5033
Entity
Organization
Contact information
Practice address
600 TOWN CENTRE DRIVE, MORGANTOWN, WV 26505-1872
(304) 598-4478
Mailing address
PO BOX 897, MORGANTOWN, WV 26507-0897
(304) 293-7401
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0011526000
—
WV
Enumeration date
02/19/2010
Last updated
02/19/2010
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