Organization

Medical Associates Of Glen Daniel

Clinic/Center in Glen Daniel, WV(View on Map)

Legal Business Name

Medical Associates Of Glen Daniel

NPI Number

1548454986

NPI Type

Organization

Enumeration Date

08/29/2007

Specialties

(Taxonomies)

Code

261Q00000X
251J00000X

Primary Taxonomy

Yes
No

Licenses

State

West Virginia

License Number

026920

Contact
Information

Purpose

Mailing
Location

Address

PO BOX 216
109 BOLT RD

City

Glen Daniel
Glen Daniel

State

WV
WV

Postal Code

25844-0216
25844-0216

Country

US
US

Telephone Number

(304) 934-5125
(304) 934-5125

Authorized Official

Name

J. Gordinho

Title or Position

OWNER/MD

Telephone Number

(304) 934-5125

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 08/29/2007

Provider Address