| |
327 Medical Park Drive Bridgeport WV 26330 | |
(681) 342-3100 | |
(681) 342-3125 |
Full Name | |
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Speciality | Internal Medicine |
Location | 327 Medical Park Drive, Bridgeport, West Virginia |
Authorized Official Name and Position | Steven Meadows (DIRECTOR OF CORPORATE COMPLIANCE) |
Authorized Official Contact | 6813421610 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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327 Medical Park Drive Bridgeport WV 26330 Ph: (681) 342-3100 | 327 Medical Park Drive Bridgeport WV 26330 Ph: (681) 342-3100 |
NPI Number | 1669501144 |
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Provider Enumeration Date | 03/02/2007 |
Last Update Date | 11/20/2023 |
Identifier | Type | State | Issuer |
---|---|---|---|
1669501144 | NPI | - | NPPES |
5100061 | Other | WV | MEDICARE PTAN |
C30572 | Other | WV | RR GROUP NUMBER |
CI9203 | Other | RR GROUP NUMBER | |
0001276003 | Other | WV | MEDICAID PROVIDER NUMBER |
CD9216 | Other | WV | RR GROUP NUMBER |
CD9217 | Other | WV | RR GROUP NUMBER |
CD9712 | Other | RR GROUP NUMBER |
Medbrook Medical Associates Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1370 Johnson Avenue, Bridgeport, WV 26330 Phone: 304-842-7186 Fax: 304-842-9005 | |
Mountainstate Infectious Disease, Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 215 W Main St Ste B, Bridgeport, WV 26330 Phone: 301-641-1822 Fax: 304-250-9933 | |