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General NPI Number Information
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NPI Number | 1548364904
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Entity Type | Organization
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Legal Business Name | CYNTHIA LEAH WALSH MD
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Dates
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Enumeration Date | 09/07/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1322 PINEVIEW DRIVE
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City | MORGANTOWN
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State | WV
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Zip | 26505
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Country | US
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Telephone | 304-599-8790
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Fax | 304-599-8790
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Provider Business Mailing Address
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Address Line | 1322 PINEVIEW DRIVE
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City | MORGANTOWN
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State | WV
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Zip | 26505
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Country | US
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Telephone | 304-599-8790
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Fax | 304-599-8795
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Authorized Official
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Title or Position | OWNER PHYSICIAN
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Name | CYNTHIA LEAH WALSH
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Credential | MD
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Telephone | 304-599-8790
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number | 18683
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License Number State | WV
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