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General NPI Number Information
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NPI Number | 1487973756
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Entity Type | Organization
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Legal Business Name | CHARLES E. PORTERFIELD
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Dates
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Enumeration Date | 05/25/2010
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Last Update Date | 05/25/2010
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Provider Practice Location Address
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Address Line | 202 3RD ST.
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City | MULLENS
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State | WV
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Zip | 25882
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Country | US
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Telephone | 304-255-5710
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Fax | 304-255-5702
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Provider Business Mailing Address
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Address Line | PO BOX 1307
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City | BECKLEY
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State | WV
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Zip | 25802-1307
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Country | US
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Telephone | 304-255-5710
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Fax | 304-255-5702
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Authorized Official
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Title or Position | PHYSICIAN
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Name | MR. CHARLES EDWIN PORTERFIELD
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Credential | D.O.
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Telephone | 304-255-5710
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QS1200X
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Taxonomy Name | Sleep Disorder Diagnostic Clinic/Center
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License Number |
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License Number State |
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