Healthcare Provider Details

I. General information

NPI: 1831494376
Provider Name (Legal Business Name): ROBIN DARNELL PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/13/2011
Last Update Date: 01/13/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4502 MACCORKLE AVE SE STE B
CHARLESTON WV
25304-1835
US

IV. Provider business mailing address

4502 MACCORKLE AVE SE STE B
CHARLESTON WV
25304-1835
US

V. Phone/Fax

Practice location:
  • Phone: 304-925-1555
  • Fax: 304-925-0396
Mailing address:
  • Phone: 304-925-1555
  • Fax: 304-925-0396

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080A0000X
TaxonomyPediatric Adolescent Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: ROBIN LEEANNE DARNELL
Title or Position: MEMBER
Credential: M.D.
Phone: 304-925-1555