MEDICARE: UNIVERSITY PHYSICIANS & SURGEONS, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician		WV
2	207V00000X	Obstetrics & Gynecology Physician		WV

General Provider Information

NPI Number	:	1518964857
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UNIVERSITY PHYSICIANS & SURGEONS, INC.

Provider Business Mailing Address
First Line	:	1600 MEDICAL CENTER DR
Second Line	:	STE B501
City	:	HUNTINGTON
State	:	WV
Zip	:	25701-3655
Country	:	US
Telephone Number	:	304-691-1640
Fax Number	:	304-691-1654

Provider Business Practice Location Address
First Line	:	1600 MEDICAL CENTER DR
Second Line	:	STE 1500
City	:	HUNTINGTON
State	:	WV
Zip	:	25701-3656
Country	:	US
Telephone Number	:	304-691-1640
Fax Number	:	304-691-1654

Authorized Official
Title or Position	:	CREDENTIALING SPECIALIST
Name	:	PAMELA LOVINS
Credential	:	CPCS
Telephone Number	:	304-691-1640

Provider Enumeration Date	:	07/01/2005
Last Update Date	:	09/11/2025

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