Organization
PINEVIEW SURGERY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRADFORD KENT MITCHELL M.D. (CHIEF EXECUTIVE OFFICER)
(304) 225-7549
Entity
Organization
Contact information
Practice address
1311 PINEVIEW DR STE 200, MORGANTOWN, WV 26505-3276
(304) 225-7549
(304) 225-7551
Mailing address
1311 PINEVIEW DR STE 200, MORGANTOWN, WV 26505-3276
(304) 225-7549
(304) 225-7551
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
20482
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
126711000
—
WV
Enumeration date
07/25/2011
Last updated
07/25/2011
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