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NPI Code Detail

MEDICARE: KEVIN WALNOHA PR

MEDICARE: KEVIN WALNOHA PR
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
1175T00000XPeer SpecialistWV
2175T00000XPeer Specialist21-9136WV

General Provider Information

NPI Number : 1891430328
Entity Type Code : Individual
Provider Name (Legal Business Name) : KEVIN WALNOHA PR
Provider Business Mailing Address
First Line : 2333 MCCORKLE AVE
Second Line :
City : SAINT ALBANS
State : WV
Zip : 25177-2073
Country : US
Telephone Number : 681-294-6861
Fax Number :
Provider Business Practice Location Address
First Line : 2333 MCCORKLE AVE
Second Line :
City : SAINT ALBANS
State : WV
Zip : 25177-2073
Country : US
Telephone Number : 681-294-6861
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/29/2022
Last Update Date : 01/31/2023

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Directions to “ KEVIN WALNOHA PR” Practice Location

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