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General NPI Number Information
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NPI Number | 1356219737
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Entity Type | Organization
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Legal Business Name | WEST VIRGINIA UNIVERSITY MEDICAL CORPORATION
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Dates
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Enumeration Date | 10/27/2025
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Last Update Date | 10/27/2025
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Provider Practice Location Address
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Address Line | 390 BIRCH ST STE B
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City | MORGANTOWN
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State | WV
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Zip | 26506-1102
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Country | US
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Telephone | 304-599-2273
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 780
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City | MORGANTOWN
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State | WV
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Zip | 26507-0780
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | VP OF FINANCE
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Name | JUSTIN GIBSON
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Credential |
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Telephone | 304-598-4256
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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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 | 208000000X
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Taxonomy Name | Pediatrics 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 | 363A00000X
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Taxonomy Name | Physician Assistant
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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 | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #8
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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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