Organization
JULIE K MCCAMMON MD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JULIE KATHRYN MCCAMMON MD (OWNER)
(304) 933-3868
Entity
Organization
Contact information
Practice address
527 MEDICAL PARK DR, SUITE 104, BRIDGEPORT, WV 26330-9007
(304) 933-3868
(304) 933-3870
Mailing address
527 MEDICAL PARK DR, SUITE 104, BRIDGEPORT, WV 26330-9007
(304) 933-3868
(304) 933-3870
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0091494000
—
WV
01
—
WV15559
STATE LICENSE
WV
Enumeration date
05/31/2006
Last updated
07/23/2014
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