Healthcare Provider Details

I. General information

NPI: 1184700304
Provider Name (Legal Business Name): MORGANTOWN ENT CLINIC INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/31/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1188 PINEVIEW DR
MORGANTOWN WV
26505
US

IV. Provider business mailing address

1188 PINEVIEW DR
MORGANTOWN WV
26505
US

V. Phone/Fax

Practice location:
  • Phone: 304-599-3959
  • Fax: 304-599-1719
Mailing address:
  • Phone: 304-599-3959
  • Fax: 304-599-1719

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number
License Number State

VIII. Authorized Official

Name: GEORGE E SNIDER JR.
Title or Position: PRESIDENT
Credential: MD
Phone: 304-599-3959