| Affiliated Specialists | |
|
600 18th St Suite 304 Parkersburg WV 26101-3231 | |
| (304) 424-4961 | |
| (314) 424-4861 |
| Full Name | Affiliated Specialists |
|---|---|
| Speciality | Pediatrics |
| Location | 600 18th St, Parkersburg, West Virginia |
| Authorized Official Name and Position | Charles Frederic Whitaker (OWNER/PRESIDENT) |
| Authorized Official Contact | 3044244961 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Affiliated Specialists 600 18th Street Suite 304 Parkersburg WV 26101 Ph: (304) 424-4961 | Affiliated Specialists 600 18th St Suite 304 Parkersburg WV 26101-3231 Ph: (304) 424-4961 |
| NPI Number | 1144314956 |
|---|---|
| Provider Enumeration Date | 10/03/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144314956 | NPI | - | NPPES |
| 3810005485 | Medicaid | WV |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 2353WV (West Virginia) | Primary |
| 208000000X | Pediatrics | WV 09456 (West Virginia) | Primary |
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