Healthcare Provider Details

I. General information

NPI: 1154642981
Provider Name (Legal Business Name): CYNTHIA ELIZABETH COLLINS STUMP D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CYNTHIA ELIZABETH COLLINS D.O.

II. Dates (important events)

Enumeration Date: 06/16/2010
Last Update Date: 08/13/2025
Certification Date: 08/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3200 MACCORKLE AVE SE
CHARLESTON WV
25304-1227
US

IV. Provider business mailing address

1540 SPRING VALLEY DRIVE
HUNTINGTON WV
25704
US

V. Phone/Fax

Practice location:
  • Phone: 304-388-5432
  • Fax:
Mailing address:
  • Phone: 304-429-6741
  • Fax: 304-429-0262

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number2560
License Number StateWV
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number2560
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: