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General NPI Number Information
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NPI Number | 1487439683
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Entity Type | Organization
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Legal Business Name | CHARLESTON AREA MEDICAL CENTER, INC.
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Dates
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Enumeration Date | 08/28/2023
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Last Update Date | 08/28/2023
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Provider Practice Location Address
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Address Line | 275 DRY HILL RD
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City | BECKLEY
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State | WV
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Zip | 25801-2605
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Country | US
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Telephone | 304-253-6060
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Fax | 304-253-6086
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Provider Business Mailing Address
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Address Line | 400 ASSOCIATION DR STE 102
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City | CHARLESTON
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State | WV
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Zip | 25311-1298
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Country | US
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Telephone | 304-388-1724
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Fax | 304-388-1721
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Authorized Official
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Title or Position | PROVIDER ENROLLMENT MANAGER
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Name | BRYAN LUZADER
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Credential |
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Telephone | 304-388-0151
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RX0202X
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Taxonomy Name | Medical Oncology Physician
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License Number |
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License Number State |
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