| |
2 Health Care Drive Philippi WV 26416-0070 | |
(304) 457-1306 | |
(304) 457-1307 |
Full Name | |
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Speciality | Internal Medicine |
Location | 2 Health Care Drive, Philippi, West Virginia |
Authorized Official Name and Position | William A San Pablo (PHYSICIAL) |
Authorized Official Contact | 3044571306 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 70 Philippi WV 26416-0070 Ph: (304) 457-1306 | 2 Health Care Drive Philippi WV 26416-0070 Ph: (304) 457-1306 |
NPI Number | 1255546750 |
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Provider Enumeration Date | 05/10/2007 |
Last Update Date | 10/15/2007 |
Identifier | Type | State | Issuer |
---|---|---|---|
1255546750 | NPI | - | NPPES |
9281882 | Other | WV | MEDICARE GROUP NUMBER |
0082862000 | Medicaid | WV |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | WV11963 (West Virginia) | Primary |