Healthcare Provider Details

I. General information

NPI: 1386682284
Provider Name (Legal Business Name): FIRST STEPS PEDIATRICS & ADOLESCENT MEDICINE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/03/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3045 PENNSYLVANIA AVE LEVEL 1 SUITE 3
WEIRTON WV
26062-3770
US

IV. Provider business mailing address

PO BOX 2304
WEIRTON WV
26062-1504
US

V. Phone/Fax

Practice location:
  • Phone: 304-723-4000
  • Fax: 304-794-7100
Mailing address:
  • Phone: 304-723-4000
  • Fax: 304-794-7100

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number StateWV

VIII. Authorized Official

Name: MARY F LITTLE
Title or Position: MANAGER OF OFFICE OPERATIONS
Credential:
Phone: 304-723-4000