Organization
APPALACHIAN MOUNTAINS MEDICAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. PATRICIA PEMBERTON KEITH (MANAGER)
(304) 719-8658
Entity
Organization
Contact information
Practice address
454 MCDOWELL ST, WELCH, WV 24801-2029
(304) 436-8685
(304) 436-6380
Mailing address
123 HUNTERS RIDGE RD, FAYETTEVILLE, WV 25840-6655
(304) 574-4384
(304) 574-4384
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
—
—
207P00000X
Emergency Medicine Physician
Primary
—
—
207Q00000X
Family Medicine Physician
—
—
207QG0300X
Geriatric Medicine (Family Medicine) Physician
—
—
207R00000X
Internal Medicine Physician
—
—
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
—
—
208000000X
Pediatrics Physician
—
—
2085B0100X
Body Imaging Physician
—
—
2085R0202X
Diagnostic Radiology Physician
—
—
208600000X
Surgery Physician
—
—
208M00000X
Hospitalist Physician
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
367500000X
Certified Registered Nurse Anesthetist
—
—
Other
Enumeration date
11/07/2013
Last updated
08/01/2016
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