Organization
OLD MILL INTERNISTS, LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KITTY R MISIEWICZ (OFFICE MANAGER)
(304) 263-7591
Entity
Organization
Contact information
Practice address
2008 PROFESSIONAL COURT, MARTINSBURG, WV 25401
(304) 263-7591
(304) 263-8318
Mailing address
PO BOX 948, MARTINSBURG, WV 25402-0948
(304) 263-8318
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
11538
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0008767001
—
WV
05
—
0082852000
—
WV
Enumeration date
02/23/2007
Last updated
08/22/2020
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