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General NPI Number Information
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NPI Number | 1003820374
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Entity Type | Organization
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Legal Business Name | MICHAEL SHRAMOWIAT LLC
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Dates
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Enumeration Date | 07/29/2006
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Last Update Date | 06/14/2013
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Provider Practice Location Address
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Address Line | 1158 46TH ST
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City | VIENNA
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State | WV
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Zip | 26105-9409
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Country | US
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Telephone | 304-295-3131
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Fax | 304-295-0700
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Provider Business Mailing Address
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Address Line | 1158 46TH ST
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City | VIENNA
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State | WV
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Zip | 26105-9409
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Country | US
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Telephone | 304-295-3131
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Fax | 304-295-0700
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Authorized Official
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Title or Position | OWNER
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Name | DR. MICHAEL E SHRAMOWIAT
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Credential | M.D.
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Telephone | 304-295-3131
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 17187
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License Number State | WV
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