Healthcare Provider Details
I. General information
NPI: 1831638519
Provider Name (Legal Business Name): EAST MOUNTAIN HEALTH PHYSICIANS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/15/2017
Last Update Date: 12/02/2017
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1008 TAVERN RD STE 202
MARTINSBURG WV
25401-2801
US
IV. Provider business mailing address
220 CAMPUS BLVD SUITE 200
WINCHESTER VA
22601
US
V. Phone/Fax
- Phone: 540-536-3228
- Fax: 540-536-3227
- Phone: 540-536-5100
- Fax: 540-536-0104
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207VM0101X |
| Taxonomy | Maternal & Fetal Medicine Physician |
| License Number | |
| License Number State | WV |
VIII. Authorized Official
Name: DR.
GERALD
J
BECHAMPS
Title or Position: CEO
Credential: MD
Phone: 304-822-4933