| West Virginia University Medical Corporation | |
|
880 N Tennessee Ave Ste 105 Martinsburg WV 25401-9401 | |
| (304) 264-8603 | |
| (304) 264-1577 |
| Full Name | West Virginia University Medical Corporation |
|---|---|
| Speciality | Psychologist |
| Location | 880 N Tennessee Ave Ste 105, Martinsburg, West Virginia |
| Authorized Official Name and Position | Justin Gibson (VP, FINANCE) |
| Authorized Official Contact | 3045984256 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| West Virginia University Medical Corporation Po Box 780 Morgantown WV 26507-0780 Ph: (304) 285-7101 | West Virginia University Medical Corporation 880 N Tennessee Ave Ste 105 Martinsburg WV 25401-9401 Ph: (304) 264-8603 |
| NPI Number | 1942058243 |
|---|---|
| Provider Enumeration Date | 05/10/2024 |
| Last Update Date | 05/10/2024 |
| Certification Date | 05/10/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942058243 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | (* (Not Available)) | Primary |
| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | (* (Not Available)) | Secondary |
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