| Bridgeport Family Medicine | |
|
1221 Johnson Ave Suite 1100 Bridgeport WV 26330-1392 | |
| (304) 848-0338 | |
| Not Available |
| Full Name | Bridgeport Family Medicine |
|---|---|
| Speciality | Family Medicine |
| Location | 1221 Johnson Ave, Bridgeport, West Virginia |
| Authorized Official Name and Position | Robert Paul Romano (OWNER) |
| Authorized Official Contact | 3048480338 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bridgeport Family Medicine 1221 Johnson Ave Suite 1100 Bridgeport WV 26330-1392 Ph: (304) 848-0338 | Bridgeport Family Medicine 1221 Johnson Ave Suite 1100 Bridgeport WV 26330-1392 Ph: (304) 848-0338 |
| NPI Number | 1275585739 |
|---|---|
| Provider Enumeration Date | 05/16/2006 |
| Last Update Date | 04/20/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275585739 | NPI | - | NPPES |
| DF7112 | Other | WV | RAILROAD MEDICARE |
| 3810010298 | Medicaid | WV |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 1675 (West Virginia) | Primary |
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