| Manchin Clinic Of Bridgeport | |
|
409 W Main St Bridgeport WV 26330-1752 | |
| (304) 367-9170 | |
| Not Available |
| Full Name | Manchin Clinic Of Bridgeport |
|---|---|
| Speciality | Family Medicine |
| Location | 409 W Main St, Bridgeport, West Virginia |
| Authorized Official Name and Position | John Manchin (OWNER) |
| Authorized Official Contact | 3043679170 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Manchin Clinic Of Bridgeport 409 W Main St Bridgeport WV 26330-1752 Ph: () - | Manchin Clinic Of Bridgeport 409 W Main St Bridgeport WV 26330-1752 Ph: (304) 367-9170 |
| NPI Number | 1386019222 |
|---|---|
| Provider Enumeration Date | 12/03/2015 |
| Last Update Date | 12/03/2015 |
| Medicare PECOS PAC ID | 7315244431 |
|---|---|
| Medicare Enrollment ID | O20160404001997 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386019222 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | John Manchin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1134231640 PECOS PAC ID: 4284717182 Enrollment ID: I20080505000166 |
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