Healthcare Provider Details

I. General information

NPI: 1487863833
Provider Name (Legal Business Name): HEALTH MANAGEMENT ASSOCIATES OF WV
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

61 E 3RD AVE
WILLIAMSON WV
25661-3530
US

IV. Provider business mailing address

PO BOX 1958
WILLIAMSON WV
25661-1958
US

V. Phone/Fax

Practice location:
  • Phone: 304-235-8999
  • Fax: 304-235-4631
Mailing address:
  • Phone: 304-235-0466
  • Fax: 304-235-0536

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number20694
License Number StateWV

VIII. Authorized Official

Name: MELINDA EDWARDS
Title or Position: ASST. PRACTICE MANAGER
Credential:
Phone: 304-235-0466