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NPI Code Detail

MEDICARE: BEE HEALTHY PEDIATRICS PLLC

MEDICARE: BEE HEALTHY PEDIATRICS PLLC
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
12080A0000XPediatric Adolescent Medicine Physician

General Provider Information

NPI Number : 1982953873
Entity Type Code : Organization
Provider Name (Legal Business Name) : BEE HEALTHY PEDIATRICS PLLC
Provider Business Mailing Address
First Line : 888 OAKWOOD RD
Second Line : SUITE 110
City : CHARLESTON
State : WV
Zip : 25314-2000
Country : US
Telephone Number : 304-342-8142
Fax Number : 304-344-0614
Provider Business Practice Location Address
First Line : 400 COURT ST
Second Line : SUITE 300
City : CHARLESTON
State : WV
Zip : 25301-1652
Country : US
Telephone Number : 304-342-8142
Fax Number : 304-344-0614
Authorized Official
Title or Position : OWNER
Name : DR. DIANA P REYNOLDS
Credential : MD
Telephone Number : 304-342-8142
Provider Enumeration Date : 09/06/2012
Last Update Date : 09/06/2012

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Directions to “BEE HEALTHY PEDIATRICS PLLC ” Practice Location

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