Organization
WEST VIRGINIA SCHOOL OF OSTEOPATHIC MEDICINE CLINIC INC D/B/A ROBERT C. BYRD CLINIC
Active
Other names
Robert C Byrd Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MARY P NEMCIK (EXECUTIVE DIRECTOR)
(304) 645-3220
Entity
Organization
Contact information
Practice address
1464 JEFFERSON ST N, LEWISBURG, WV 24901-1380
(304) 645-3220
(304) 645-4103
Mailing address
1464 JEFFERSON ST N, LEWISBURG, WV 24901-1380
(304) 645-3220
(304) 645-4103
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
208000000X
Pediatrics Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0006045000
—
WV
Enumeration date
06/22/2006
Last updated
01/30/2025
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