Healthcare Provider Details

I. General information

NPI: 1194592881
Provider Name (Legal Business Name): SARAH ANN HUDACHECK
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/04/2023
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 MEDICAL CENTER DR
MORGANTOWN WV
26506-1200
US

IV. Provider business mailing address

487 PINEWOOD DR
WEIRTON WV
26062-5571
US

V. Phone/Fax

Practice location:
  • Phone: 304-293-1272
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number3224
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: