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Organization

CENTER FOR ALTERNATIVE MEDICINE

Active
Other names
Center for Alternative Medicine
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JOHN PATRICK MACCALLUM MD (PHYSICIAN)
(304) 757-3368
Entity
Organization

Contact information

Practice address
300B PRESTIGE PARK DR, HURRICANE, WV 25526-8419
(304) 757-3368
(304) 757-2402
Mailing address
300B PRESTIGE PARK DR, HURRICANE, WV 25526-8419
(304) 757-3368
(304) 757-2402

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
10463012
WV
207Q00000X
Family Medicine Physician
Primary
10463012
WV
2084P0800X
Psychiatry Physician
10463012
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
001710972
BLUE CROSS BLUE SHIELD
WV
05
0116818000
WV
Enumeration date
04/24/2007
Last updated
11/18/2011
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