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686 South Pike St Shinnston WV 26431-1043 | |
(304) 592-2100 | |
(304) 592-2102 |
Full Name | |
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Speciality | Family Medicine |
Location | 686 South Pike St, Shinnston, West Virginia |
Authorized Official Name and Position | John C Forester (CHIEF EXECUTIVE OFFICER) |
Authorized Official Contact | 3046244655 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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686 S Pike St Ste A Shinnston WV 26431-1043 Ph: (304) 624-4655 | 686 South Pike St Shinnston WV 26431-1043 Ph: (304) 592-2100 |
NPI Number | 1477621985 |
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Provider Enumeration Date | 12/01/2006 |
Last Update Date | 01/08/2009 |
Identifier | Type | State | Issuer |
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1477621985 | NPI | - | NPPES |
4000134000 | Medicaid | WV |