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General NPI Number Information
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NPI Number | 1285131144
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Entity Type | Organization
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Legal Business Name | CHARLESTON SURGICAL HOSPITAL HEALTHCARE GROUP, PLLC
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Dates
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Enumeration Date | 04/09/2018
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Last Update Date | 08/11/2023
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Provider Practice Location Address
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Address Line | 1306 KANAWHA BLVD E
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City | CHARLESTON
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State | WV
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Zip | 25301-3000
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Country | US
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Telephone | 304-343-4371
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Fax |
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Provider Business Mailing Address
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Address Line | 1306 KANAWHA BLVD E
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City | CHARLESTON
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State | WV
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Zip | 25301-3000
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Country | US
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Telephone | 304-343-4371
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | CHRISTINA ARVON
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Credential |
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Telephone | 304-353-0303
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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