Organization
CHARLESTON FAMILY HEALTH ASSOC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DEBRA LYNN FR (MANAGER)
(304) 345-8500
Entity
Organization
Contact information
Practice address
1218 VIRGINIA STREET EAST, SUITE A, CHARLESTON, WV 25301
(304) 345-8500
(304) 345-8979
Mailing address
1218 VIRGINIA STREET EAST, SUITE A, CHARLESTON, WV 25301
(304) 345-8500
(304) 345-8979
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
17020
WV
207Q00000X
Family Medicine Physician
Primary
17129
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0011206000
—
WV
Enumeration date
09/27/2006
Last updated
08/22/2020
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