Individual
BERNADETTE LUBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
4602 MACCORKLE AVE SE, CHARLESTON, WV 25304-1848
(304) 205-7535
(304) 205-7549
Mailing address
104 ALEX LN, CHARLESTON, WV 25304-2952
(304) 734-2040
(304) 734-2047
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
870
WV
363A00000X
Physician Assistant
9117743
FL
Other
Enumeration date
04/11/2023
Last updated
09/07/2023
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