Cranberry Medical Clinic | |
603b W State Ave Terra Alta WV 26764-1223 | |
(304) 789-2457 | |
(304) 789-6812 |
Full Name | Cranberry Medical Clinic |
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Speciality | Family Medicine |
Location | 603b W State Ave, Terra Alta, West Virginia |
Authorized Official Name and Position | Norma Keim (OFFICE MANAGER) |
Authorized Official Contact | 3047892457 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Cranberry Medical Clinic 603b W State Ave Terra Alta WV 26764-1223 Ph: (304) 789-2457 | Cranberry Medical Clinic 603b W State Ave Terra Alta WV 26764-1223 Ph: (304) 789-2457 |
NPI Number | 1508981291 |
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Provider Enumeration Date | 03/20/2007 |
Last Update Date | 02/08/2010 |
Identifier | Type | State | Issuer |
---|---|---|---|
1508981291 | NPI | - | NPPES |
0201807000 | Medicaid | WV | |
CM7276 | Other | WV | MEDICARE RAILROAD |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 12705 (West Virginia) | Primary |