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West Virginia University Medical Corporation

Organization Active NPI Psychologist · Shepherdstown, WV

NPI 1457100331 · NPPES record last updated May 14, 2024

Key facts

NPI
1457100331
Entity type
Organization (NPI type 2)
Primary specialty
Psychologist 103T00000X
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

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Tax ID family
Physician Office Center Dbauha Lab (204 organizations share this tax ID)
Part of
Physician Office Center Dbauha Lab

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist
Group: 193200000X MULTI-SPECIALTY GROUP		 103T00000X Yes
Clinical Psychologist
Group: 193200000X MULTI-SPECIALTY GROUP		 103TC0700X
Psychiatry Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 2084P0800X
Psychiatric/Mental Health Nurse Practitioner
Group: 193200000X MULTI-SPECIALTY GROUP		 363LP0808X

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

All providers in Shepherdstown, WV · Psychologist in West Virginia

Sources for this page

Verify at the official NPI Registry.