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)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