Organization
BRUCETON MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT PHARES MD (OWNER)
(304) 379-7600
Entity
Organization
Contact information
Practice address
198 MORGANTOWN STREET, SUITE B, BRUCETON MILLS, WV 26525
(304) 379-7600
(304) 379-7599
Mailing address
PO BOX 50, BRUCETON MILLS, WV 26525-1150
(304) 379-7600
(304) 379-7599
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2005711000
—
WV
Enumeration date
03/02/2012
Last updated
07/31/2013
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