Organization
WEST VIRGINIA UNIVERSITY MEDICAL CORPORATION
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
JUSTIN GIBSON (VP, FINANCE)
(304) 598-4256
Entity
Organization
Contact information
Practice address
880 N TENNESSEE AVE STE 105, MARTINSBURG, WV 25401-9401
(304) 264-8603
(304) 264-1577
Mailing address
PO BOX 780, MORGANTOWN, WV 26507-0780
(304) 285-7101
(304) 293-6963
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Enumeration date
05/10/2024
Last updated
05/10/2024
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