Individual
DR. MYRA D. PRIDDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
315 FAIRVIEW HEIGHTS RD, SUMMERSVILLE, WV 26651-1086
(304) 872-5213
(304) 872-5893
Mailing address
127 HIDDEN VALLEY ESTS, SCOTT DEPOT, WV 25560-9300
(304) 253-9355
(304) 253-0018
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
19575
WV
207Q00000X
Family Medicine Physician
Primary
19575
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
20150000
—
WV
Enumeration date
01/31/2007
Last updated
12/09/2016
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