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General NPI Number Information
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NPI Number | 1720108582
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Entity Type | Organization
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Legal Business Name | CHARLES E PORTERFIELD DO
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Dates
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Enumeration Date | 03/29/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3771 ROBERT C BYRD DRIVE
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City | BECKLEY
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State | WV
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Zip | 25801
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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 | CHARLES E PORTERFIELD
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Credential | DO
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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 | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | 1084
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License Number State | WV
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