| Medical Associates Of Glen Daniels, Pllc | |
|
264 Coal River Rd Glen Daniel WV 25844-9402 | |
| (304) 934-5125 | |
| (304) 934-6967 |
| Full Name | Medical Associates Of Glen Daniels, Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 264 Coal River Rd, Glen Daniel, West Virginia |
| Authorized Official Name and Position | J Jorge Gordinho (OWNER) |
| Authorized Official Contact | 3049345125 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Medical Associates Of Glen Daniels, Pllc Po Box 216 Glen Daniel WV 25844 Ph: (304) 934-5125 | Medical Associates Of Glen Daniels, Pllc 264 Coal River Rd Glen Daniel WV 25844-9402 Ph: (304) 934-5125 |
| NPI Number | 1730216557 |
|---|---|
| Provider Enumeration Date | 02/28/2007 |
| Last Update Date | 06/05/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730216557 | NPI | - | NPPES |
| 3810003365 | Medicaid | WV |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 16005 (West Virginia) | Primary |
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