Healthcare Provider Details

I. General information

NPI: 1801974233
Provider Name (Legal Business Name): MARIO R SCHWABE & ASSOCIATES PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/02/2006
Last Update Date: 11/04/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3194 CORE RD
PARKERSBURG WV
26104-1556
US

IV. Provider business mailing address

3199 CORE RD
PARKERSBURG WV
26104-1557
US

V. Phone/Fax

Practice location:
  • Phone: 304-485-5185
  • Fax: 304-485-0051
Mailing address:
  • Phone: 304-485-5185
  • Fax: 304-485-1373

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: ERIK J. SAMS
Title or Position: CEO
Credential: MBA
Phone: 304-485-5185