Organization
BSIM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROSEMARIE REYNOLDS (PHYSICIAN PRACTICE MANAGER)
(540) 247-2701
Entity
Organization
Contact information
Practice address
226 GAYLE DR, BERKELEY SPRINGS, WV 25411-6301
(304) 258-9433
(304) 258-6063
Mailing address
136 LINDEN DR, SUITE 104, WINCHESTER, VA 22601-2818
(540) 678-3588
(540) 678-9025
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
16325
WV
Other
Enumeration date
12/13/2007
Last updated
12/13/2007
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