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General NPI Number Information
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NPI Number | 1811877442
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Entity Type | Organization
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Legal Business Name | CORNERSTONE MEDICAL GROUP OF WEST VIRGINIA LLC
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Dates
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Enumeration Date | 09/04/2025
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Last Update Date | 09/04/2025
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Provider Practice Location Address
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Address Line | 428 LEON SULLIVAN WAY
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City | CHARLESTON
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State | WV
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Zip | 25301-1713
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Country | US
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Telephone | 681-535-2277
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Fax | 740-619-7029
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Provider Business Mailing Address
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Address Line | 27799 STATE ROUTE 7
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City | CHESHIRE
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State | OH
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Zip | 45620-9603
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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 | NURSE PRACTITIONER
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Name | JERI THOMAS
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Credential | DNP, NP-C
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Telephone | 740-590-1181
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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