Organization
BRIAN POWDERLY MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN POWDERLY MD (OWNER)
(304) 422-8112
Entity
Organization
Contact information
Practice address
2675 36TH ST, PARKERSBURG, WV 26104-8024
(304) 422-8112
(304) 422-3924
Mailing address
301 SAINT ANDREWS BLVD, BELPRE, OH 45714-9327
(304) 422-8112
(304) 422-3924
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2125417
—
OH
05
—
3810006475
—
WV
Enumeration date
02/02/2007
Last updated
11/01/2016
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