Healthcare Provider Details

I. General information

NPI: 1518058049
Provider Name (Legal Business Name): PANHANDLE MEDICINE OF INWOOD, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/28/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

365 MIDDLEWAY PIKE
INWOOD WV
25428-1845
US

IV. Provider business mailing address

PO BOX 1845
INWOOD WV
25428-1845
US

V. Phone/Fax

Practice location:
  • Phone: 304-229-7630
  • Fax: 304-229-7689
Mailing address:
  • Phone: 304-229-7630
  • Fax: 304-229-7689

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number54825
License Number StateWV

VIII. Authorized Official

Name: DR. JOHN COLLETT VELTMAN
Title or Position: OWNER
Credential: M.D.
Phone: 304-229-7630