Healthcare Provider Details

I. General information

NPI: 1659563104
Provider Name (Legal Business Name): WVUH-EAST SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2007
Last Update Date: 04/22/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 FOUNDATION WAY MARTINSBURG ANESTHESIA
MARTINSBURG WV
25401-9003
US

IV. Provider business mailing address

109 MOUNT WOOD RD MARTINSBURG ANESTHESIA
WHEELING WV
26003-2632
US

V. Phone/Fax

Practice location:
  • Phone: 304-233-2455
  • Fax: 304-233-6073
Mailing address:
  • Phone: 304-233-2455
  • Fax: 304-233-6073

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State

VIII. Authorized Official

Name: CHRISTOPHER KNIGHT
Title or Position: CFO
Credential:
Phone: 304-260-1436