| Bensenhaver Medical Practice | |
|
100 Hospital Dr Ste 1 Petersburg WV 26847-9570 | |
| (304) 257-1944 | |
| (304) 257-9524 |
| Full Name | Bensenhaver Medical Practice |
|---|---|
| Speciality | Family Medicine |
| Location | 100 Hospital Dr Ste 1, Petersburg, West Virginia |
| Authorized Official Name and Position | Renee Nevada Johnson (CREDENTIALING COORDINATOR) |
| Authorized Official Contact | 5405360103 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bensenhaver Medical Practice 220 Campus Blvd Ste 200 Winchester VA 22601-2889 Ph: (540) 536-5100 | Bensenhaver Medical Practice 100 Hospital Dr Ste 1 Petersburg WV 26847-9570 Ph: (304) 257-1944 |
| NPI Number | 1093219628 |
|---|---|
| Provider Enumeration Date | 03/20/2018 |
| Last Update Date | 12/30/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093219628 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (West Virginia) | Secondary |
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 208800000X | Urology | (* (Not Available)) | Secondary |
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