Healthcare Provider Details

I. General information

NPI: 1497891220
Provider Name (Legal Business Name): PRIORITY CARE MEDICAL GROUP, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/29/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

918 CHESTNUT RIDGE RD SUITE 9
MORGANTOWN WV
26505-2822
US

IV. Provider business mailing address

918 CHESTNUT RIDGE RD SUITE 9
MORGANTOWN WV
26505-2822
US

V. Phone/Fax

Practice location:
  • Phone: 304-598-2632
  • Fax: 304-599-1952
Mailing address:
  • Phone: 304-598-2632
  • Fax: 304-599-1952

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2081S0010X
TaxonomySports Medicine (Physical Medicine & Rehabilitation) Physician
License NumberWV12617
License Number StateWV
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number709
License Number StateWV

VIII. Authorized Official

Name: EMMANUEL MUNOZ
Title or Position: PRESIDENT
Credential: M.D.
Phone: 304-598-2632