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General NPI Number Information
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NPI Number | 1114162765
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Entity Type | Organization
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Legal Business Name | RIVERVIEW PRIMARY CARE
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Dates
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Enumeration Date | 12/11/2008
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Last Update Date | 06/16/2025
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Provider Practice Location Address
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Address Line | 1217 BLIZZARD DR
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City | PARKERSBURG
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State | WV
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Zip | 26101-6152
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Country | US
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Telephone | 49-161-7203
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Fax | 304-916-1723
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Provider Business Mailing Address
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Address Line | 1217 BLIZZARD DR
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City | PARKERSBURG
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State | WV
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Zip | 26101-6152
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Country | US
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Telephone | 304-916-1720
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Fax | 304-916-1723
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Authorized Official
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Title or Position | OWNER
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Name | DR. BRANDON M. WOLFE
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Credential | DO
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Telephone | 49-161-7203
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State | WV
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