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General NPI Number Information
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NPI Number | 1407180888
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Entity Type | Organization
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Legal Business Name | VALEO MEDICAL, PLLC
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Dates
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Enumeration Date | 10/01/2009
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Last Update Date | 09/28/2016
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Provider Practice Location Address
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Address Line | 260 RUSSELL AVE 260 RUSSELL AVE
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City | NEW MARTINSVILLE
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State | WV
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Zip | 26155-1571
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Country | US
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Telephone | 304-398-4949
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Fax | 304-398-4952
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Provider Business Mailing Address
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Address Line | 800 GRAND CENTRAL MALL STE 11
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City | VIENNA
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State | WV
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Zip | 26105-4100
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Country | US
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Telephone | 304-916-1270
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Fax | 304-916-1705
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Authorized Official
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Title or Position | OWNER
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Name | DR. GREGORY EVAN KRAUSE
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Credential | MD
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Telephone | 304-916-1270
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number | 99GQ3
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License Number State | WV
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