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General NPI Number Information
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NPI Number | 1346341716
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Entity Type | Organization
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Legal Business Name | WESTERN MARYLAND HEALTH SYSTEM CORPORATION
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Dates
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Enumeration Date | 09/26/2006
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Last Update Date | 10/02/2019
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Provider Practice Location Address
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Address Line | 45 HUNT CLUB DR
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City | RIDGELEY
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State | WV
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Zip | 26753-7567
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Country | US
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Telephone | 304-726-4501
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Fax | 304-726-4051
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Provider Business Mailing Address
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Address Line | 45 HUNT CLUB DR
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City | RIDGELEY
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State | WV
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Zip | 26753-7567
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Country | US
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Telephone | 304-726-4501
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Fax | 304-726-4051
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Authorized Official
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Title or Position | SR VP CFO
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Name | KIMBERLY S REPAC
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Credential |
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Telephone | 240-964-8003
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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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 |
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Taxonomy #3
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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