| Petersburg Medical Group Ii | |
|
Memorial Dr Petersburg WV 26847 | |
| (304) 257-4511 | |
| (304) 257-4511 |
| Full Name | Petersburg Medical Group Ii |
|---|---|
| Speciality | Family Medicine |
| Location | Memorial Dr, Petersburg, West Virginia |
| Authorized Official Name and Position | Larry C Rogers (OWNER) |
| Authorized Official Contact | 3042574511 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Petersburg Medical Group Ii Memorial Dr Box 7 Petersburg WV 26847 Ph: (304) 257-4511 | Petersburg Medical Group Ii Memorial Dr Petersburg WV 26847 Ph: (304) 257-4511 |
| NPI Number | 1538347943 |
|---|---|
| Provider Enumeration Date | 02/07/2008 |
| Last Update Date | 08/19/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538347943 | NPI | - | NPPES |
| 0055759000 | Medicaid | WV |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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