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General NPI Number Information
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NPI Number | 1528852951
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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 | 04/09/2025
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Last Update Date | 04/09/2025
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Provider Practice Location Address
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Address Line | 33 MEDICAL CENTER DR
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City | MORGANTOWN
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State | WV
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Zip | 26505-4024
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Country | US
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Telephone | 304-598-4740
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Fax | 304-293-3766
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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 | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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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 | 2084B0040X
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Taxonomy Name | Behavioral Neurology & Neuropsychiatry 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 | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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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 | 2084P0805X
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Taxonomy Name | Geriatric Psychiatry Physician
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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