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Individual

DR. CRYSTAL H BASTIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
4820 KENTUCKY ST, SOUTH CHARLESTON, WV 25309
(304) 720-0390
(304) 720-0391
Mailing address
4605 MACCORKLE AVE SW, THS PHYSICIAN PARTNERS, INC. - ADMIN OFC, SOUTH CHARLESTON, WV 25309-1311
(304) 414-4800
(304) 414-4801

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
20368
WV

Other

Enumeration date
05/12/2006
Last updated
01/13/2022
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