Healthcare Provider Details
I. General information
NPI: 1225502826
Provider Name (Legal Business Name): WEST VIRGINIA FERTILITY INSTITUTE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/16/2019
Last Update Date: 11/15/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
108 WASHINGTON ST W STE 11
CHARLESTON WV
25302-2344
US
IV. Provider business mailing address
3821 FORRESTGATE DR
WINSTON SALEM NC
27103-2930
US
V. Phone/Fax
- Phone: 336-448-9100
- Fax: 336-778-7995
- Phone: 336-448-9100
- Fax: 336-778-7995
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207VE0102X |
| Taxonomy | Reproductive Endocrinology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MEHMET
TAMER
YALCINKAYA
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 336-448-9100