| Mountaineer Family Medicine, Inc. | |
|
500 Poplar St Suite 204 Charleston WV 25309-1474 | |
| (304) 767-7840 | |
| (304) 767-7849 |
| Full Name | Mountaineer Family Medicine, Inc. |
|---|---|
| Speciality | Family Medicine |
| Location | 500 Poplar St, Charleston, West Virginia |
| Authorized Official Name and Position | Mohamad Samah Kalou (OWNER) |
| Authorized Official Contact | 3047677840 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mountaineer Family Medicine, Inc. Po Box 11908 Charleston WV 25339-1908 Ph: (304) 767-7840 | Mountaineer Family Medicine, Inc. 500 Poplar St Suite 204 Charleston WV 25309-1474 Ph: (304) 767-7840 |
| NPI Number | 1295874436 |
|---|---|
| Provider Enumeration Date | 02/05/2007 |
| Last Update Date | 02/04/2008 |
| Medicare PECOS PAC ID | 5496858102 |
|---|---|
| Medicare Enrollment ID | O20070319000427 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295874436 | NPI | - | NPPES |
| 3810010965 | Medicaid | WV |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 22493 (West Virginia) | Primary |
| Provider Name | Mohamad S Kalou |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1619065190 PECOS PAC ID: 4183622517 Enrollment ID: I20061120000365 |
| Provider Name | Michael S Pauley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1770661001 PECOS PAC ID: 7517004450 Enrollment ID: I20091026000068 |
| Provider Name | Crystal L Watkins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790272607 PECOS PAC ID: 0648515841 Enrollment ID: I20181217000985 |
| Provider Name | William Ray Watkins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104395375 PECOS PAC ID: 5496097594 Enrollment ID: I20190419000199 |
| Provider Name | Kerri Anne Spry-lambert |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467013243 PECOS PAC ID: 8022345826 Enrollment ID: I20190815002340 |
| Provider Name | Betsy D Thornton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861660706 PECOS PAC ID: 8325375116 Enrollment ID: I20190816002087 |
| Provider Name | Jamie Brumfield |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760046387 PECOS PAC ID: 9133457740 Enrollment ID: I20190821000316 |
| Provider Name | Tabitha Lynn Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073003117 PECOS PAC ID: 0840521811 Enrollment ID: I20191007002095 |
| Provider Name | Amy Lee West |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174138515 PECOS PAC ID: 6406268838 Enrollment ID: I20201209001160 |
| Provider Name | Printess Lawrence |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124667266 PECOS PAC ID: 3375950314 Enrollment ID: I20210318001704 |
| Provider Name | Karlie Michelle Perkins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336735679 PECOS PAC ID: 6608283940 Enrollment ID: I20210401001891 |
| Provider Name | Tina L Brown-cohenour |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093277923 PECOS PAC ID: 2365872124 Enrollment ID: I20210413001285 |
| Provider Name | Melissa A Kirk |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720730542 PECOS PAC ID: 5597143073 Enrollment ID: I20220613001406 |
| Provider Name | Bretney Huff |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497444723 PECOS PAC ID: 0042668840 Enrollment ID: I20231204002040 |
Capitol United Support Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 415 Quarrier St, Suite 213, Charleston, WV 25301 Phone: 304-410-9442 | |
Valley Health Systems, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 864 Oakwood Rd, Charleston, WV 25314 Phone: 304-343-2807 Fax: 304-525-3338 | |
Charleston Internal Medicine Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 3701 Maccorkle Ave Se, Charleston, WV 25304 Phone: 304-720-2345 Fax: 304-720-2347 | |
Kceaa Health And Wellness Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 601 Brooks St, Charleston, WV 25301 Phone: 304-346-8877 Fax: 304-414-5218 | |
Cabin Creek Health Center, Inc. At Kchd Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 108 Lee St E, Charleston, WV 25301 Phone: 304-734-2040 Fax: 304-734-2047 | |
Valley Health Systems, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 333 Laidley St Fl 6, Charleston, WV 25301 Phone: 304-347-6500 Fax: 304-525-3338 | |
Hope For Tomorrow, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2152 Greenbrier St, Charleston, WV 25311 Phone: 304-857-6494 Fax: 214-850-9018 |