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Charleston Area Medical Center, Inc.

Organization Active NPI Otolaryngology Physician · Charleston, WV

NPI 1598544975 · NPPES record last updated Sep 26, 2023

Key facts

NPI
1598544975
Entity type
Organization (NPI type 2)
Primary specialty
Otolaryngology Physician 207Y00000X
Legal business name
CHARLESTON AREA MEDICAL CENTER, INC.
Practice address
1311 Virginia St E Ste 100
Charleston, WV 25301-3011
Phone
(304) 353-0210
NPI assigned
Sep 26, 2023
Organization subpart
No

Authorized official

Name
Bryan Luzader
Title
Provider Enrollment Manager
Phone
(304) 388-0151

Corporate family (same tax ID) 28

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

View all 28

National Provider Directory

Tax ID family
Camc Physicians Health (29 organizations share this tax ID)

Locations

1311 Virginia St E
Ste 100
Charleston, WV 25301
Phone (304) 343-4371

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician
Group: 193400000X SINGLE SPECIALTY GROUP		 207Y00000X Yes

Addresses

Primary practice location

1311 Virginia St E Ste 100
Charleston, WV 25301-3011

Mailing address

400 Association Dr Ste 102
Charleston, WV 25311-1298
Phone (304) 388-1724

Other names

  • CAMC Pediatric & Adult ENT Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Sep 26, 2023.

{
    "created_epoch": "1695686400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695686400000",
    "number": "1598544975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 ASSOCIATION DR STE 102",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253111298",
            "telephone_number": "304-388-1724",
            "fax_number": "304-388-1721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1311 VIRGINIA ST E STE 100",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253013011",
            "telephone_number": "304-353-0210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLESTON AREA MEDICAL CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-26",
        "last_updated": "2023-09-26",
        "certification_date": "2023-09-26",
        "status": "A",
        "authorized_official_last_name": "LUZADER",
        "authorized_official_first_name": "BRYAN",
        "authorized_official_title_or_position": "PROVIDER ENROLLMENT MANAGER",
        "authorized_official_telephone_number": "304-388-0151"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CAMC Pediatric & Adult ENT",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Charleston, WV

All providers in Charleston, WV · Otolaryngology Physician in West Virginia

Sources for this page

Verify at the official NPI Registry.