Grant Pediatrics And Internal Medicine is a medicare enrolled dental clinic (Clinic/center - Federally Qualified Health Center (fqhc)) in Petersburg, West Virginia. The current practice location for Grant Pediatrics And Internal Medicine is 111 S Grove St Ste 1, Petersburg, West Virginia. For appointments, you can reach them via phone at
(304) 257-2451. The mailing address for Grant Pediatrics And Internal Medicine is Po Box 97, Baker, West Virginia and phone number is (304) 897-5915.
Grant Pediatrics And Internal Medicine is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its
NPI number is 1033347414. This medical practice
accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at
(304) 257-2451.
Dental Care Clinic Profile
| Full Name | Grant Pediatrics And Internal Medicine |
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| Speciality | Clinic/Center |
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| Location | 111 S Grove St Ste 1, Petersburg, West Virginia |
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| Authorized Official Name and Position | Melissa Thompson (CEO) |
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| Authorized Official Contact | 3048975915 |
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| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
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Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Grant Pediatrics And Internal Medicine
Po Box 97
Baker
WV 26801-0097
Ph: (304) 897-5915 | Grant Pediatrics And Internal Medicine
111 S Grove St Ste 1
Petersburg
WV 26847-1770
Ph: (304) 257-2451 |
NPI Details:
| NPI Number | 1033347414 |
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| Provider Enumeration Date | 06/24/2009 |
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| Last Update Date | 01/16/2024 |
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Medicare PECOS Information:
| Medicare PECOS PAC ID | 6204728041 |
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| Medicare Enrollment ID | O20090623000048 |
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Medical Identifiers
Medical identifiers for Grant Pediatrics And Internal Medicine such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1033347414 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 122300000X | Dentist | (* (Not Available)) | Secondary |
| 124Q00000X | Dental Hygienist | (* (Not Available)) | Secondary |
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
| 208000000X | Pediatrics | (* (Not Available)) | Secondary |
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
| 363A00000X | Physician Assistant | (* (Not Available)) | Secondary |
| 363L00000X | Nurse Practitioner | (* (Not Available)) | Secondary |
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