West Virginia University Medical Corporation
Organization Active NPI Family Medicine Physician · Shepherdstown, WV
NPI 1295584167 · NPPES record last updated May 14, 2024
Key facts
- NPI
- 1295584167
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- WEST VIRGINIA UNIVERSITY MEDICAL CORPORATION
- Practice address
- 60 Maclaine Way Ste a
Shepherdstown, WV 25443-1667 - Phone
- (304) 876-6343
- Fax
- (304) 901-7024
- NPI assigned
- May 14, 2024
- Organization subpart
- Yes
- Parent organization (as reported)
- WEST VIRGINIA UNIVERSITY MEDICAL CORPORATION
Authorized official
- Name
- Justin Gibson
- Title
- VP, Finance
- Phone
- (304) 598-4256
Corporate family (same tax ID) 24
Practitioners 1
National Provider Directory
- Tax ID family
- Physician Office Center Dbauha Lab
- Part of
- Physician Office Center Dbauha Lab
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | Yes | ||
| Internal Medicine Physician |
207R00000X | |||
| Endocrinology, Diabetes & Metabolism Physician |
207RE0101X | |||
| Rheumatology Physician |
207RR0500X | |||
| Pediatrics Physician |
208000000X | |||
| Family Nurse Practitioner |
363LF0000X |
Addresses
Primary practice location
60 Maclaine Way Ste a
Shepherdstown, WV 25443-1667
Mailing address
PO Box 780
Morgantown, WV 26507-0780
Phone (304) 285-7101
Other providers in Shepherdstown, WV
- Walgreen Co.
- Charice Washington
- Denzel Washington
- Teresa Ann Wenner
- Ashley Wertman
- West Virginia University Medical Corporation
- West Virginia University Medical Corporation
- Tim L Whetzel
- Dakari Williams
- Lianne Zatezalo
All providers in Shepherdstown, WV · Family Medicine Physician in West Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 14, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.