Healthcare Provider Details

I. General information

NPI: 1558312876
Provider Name (Legal Business Name): TWIN VALLEY MEDICAL CENTER PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/12/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 N. WALNUT ST.
MORGANTOWN PA
19543
US

IV. Provider business mailing address

P.O. BOX 529
MORGANTOWN PA
19543
US

V. Phone/Fax

Practice location:
  • Phone: 610-286-9071
  • Fax: 610-286-6760
Mailing address:
  • Phone: 610-286-9071
  • Fax: 610-286-6760

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MARIE SCHILDT
Title or Position: OFFICE MANAGER
Credential:
Phone: 64102869071