West Virginia University Medical Corporation
Orthopaedic Surgery in Charles Town, WV. Organization (NPI-2).
NPI number1104794239
StatusActive
Last updated in NPPESOct 29, 2025
Details
- NPI
- 1104794239
- Entity type
- Organization (NPI-2)
- Legal business name
- West Virginia University Medical Corporation
- Organization subpart
- Yes
- Enumeration date
- Oct 29, 2025
- Certification date
- Oct 29, 2025
- Last updated
- Oct 29, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207X00000X | Orthopaedic Surgery | – | – | Yes |
| 363A00000X | Physician Assistant | – | – | |
| 207XP3100X | Orthopaedic Surgery, Pediatric Orthopaedic Surgery | – | – |
Practice location
912 Somerset BlvdCharles Town, WV 25414-3953
Phone 304-598-4830
Mailing address
Po Box 780Morgantown, WV 26507-0780
Authorized official
Justin Gibson
Vp Of Finance
3045984256
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