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Organization

PRESTON COUNTY PEDIATRICS & INTERNAL MEDICINE - UHA

Active
Parent organization
WEST VIRGINIA UNIVERSITY MEDICAL CORPORATION
Organization subpart
Yes

Provider details

NPI number
Legal business name
WEST VIRGINIA UNIVERSITY MEDICAL CORPORATION
Authorized official
ROBYN M MCDANIEL (PROVIDER RELATIONS SUPERVISOR)
(304) 293-5033
Entity
Organization

Contact information

Practice address
14 COMFORT DRIVE, REEDSVILLE, WV 26547
(304) 864-0006
Mailing address
PO BOX 780, MORGANTOWN, WV 26507-0780
(304) 293-7401
(304) 293-6963

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0011526000
WV
Enumeration date
07/29/2009
Last updated
07/29/2009
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