| Wvupc-women & Childrens Staff | |
|
830 Penn Ave Charleston WV 25302-3302 | |
| (304) 388-1552 | |
| Not Available |
| Full Name | Wvupc-women & Childrens Staff |
|---|---|
| Speciality | Family Medicine |
| Location | 830 Penn Ave, Charleston, West Virginia |
| Authorized Official Name and Position | Robyn M Mcdaniel (PROVIDER RELATIONS SUPERVISOR) |
| Authorized Official Contact | 3042935033 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Wvupc-women & Childrens Staff Po Box 7000 Morgantown WV 26507-7000 Ph: (304) 293-7401 | Wvupc-women & Childrens Staff 830 Penn Ave Charleston WV 25302-3302 Ph: (304) 388-1552 |
| NPI Number | 1174777502 |
|---|---|
| Provider Enumeration Date | 11/12/2008 |
| Last Update Date | 11/12/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174777502 | NPI | - | NPPES |
| 4002106000 | Medicaid | WV |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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