West Virginia University Medical Corporation
Psychologist in Shepherdstown, WV. Organization (NPI-2).
NPI number1457100331
StatusActive
Last updated in NPPESMay 14, 2024
Details
- NPI
- 1457100331
- Entity type
- Organization (NPI-2)
- Legal business name
- West Virginia University Medical Corporation
- Organization subpart
- Yes
- Enumeration date
- May 14, 2024
- Certification date
- May 14, 2024
- Last updated
- May 14, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 103T00000X | Psychologist | – | – | Yes |
| 103TC0700X | Psychologist, Clinical | – | – | |
| 2084P0800X | Psychiatry & Neurology, Psychiatry | – | – | |
| 363LP0808X | Nurse Practitioner, Psych/Mental Health | – | – |
Practice location
60 Maclaine Way Ste AShepherdstown, WV 25443-1667
Phone 304-876-6343 · Fax 304-901-7024
Mailing address
Po Box 780Morgantown, WV 26507-0780
Phone 304-285-7101 · Fax 304-293-6963
Authorized official
Justin Gibson
Vp, Finance
3045984256
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Other Psychologist providers in Shepherdstown, WV
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- Irving Tucker, PH.D.NPI 1720390461
All 5 Psychologist providers in Shepherdstown · All 159 providers in Shepherdstown
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