Organization
MID-OHIO VALLEY MEDICAL GROUP, INC.
Active
Parent organization
MID-OHIO VALLEY MEDICAL GROUP INC
Other names
MOVMG LAB
Organization subpart
Yes
Provider details
NPI number
Legal business name
MID-OHIO VALLEY MEDICAL GROUP INC
Authorized official
ROBERT RANDAL HEAVNER M.D. (PRESIDENT)
(304) 485-3303
Entity
Organization
Contact information
Practice address
800 GRAND CENTRAL MALL, SUITE 4, VIENNA, WV 26105-4131
(304) 485-3300
(304) 485-3317
Mailing address
PO BOX 1669, PARKERSBURG, WV 26102-1669
(304) 485-3300
(304) 485-3317
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6703034000
—
WV
Enumeration date
10/10/2006
Last updated
10/29/2007
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