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NPI Code Detail

MEDICARE: MEDEXPRESS URGENT CARE PLLC-MORGANTOWN

MEDICARE: MEDEXPRESS URGENT CARE PLLC-MORGANTOWN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207P00000XEmergency Medicine Physician
2261QU0200XUrgent Care Clinic/Center

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
100043OTHERWVSTATE LICENSE
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
351D0990987OTHERWVCLIA

General Provider Information

NPI Number : 1235138280
Entity Type Code : Organization
Provider Name (Legal Business Name) : MEDEXPRESS URGENT CARE PLLC-MORGANTOWN
Provider Business Mailing Address
First Line : 1751 EARL L CORE ROAD
Second Line :
City : MORGANTOWN
State : WV
Zip : 26505
Country : US
Telephone Number : 304-225-2500
Fax Number : 304-985-6350
Provider Business Practice Location Address
First Line : 215 DON KNOTTS BLVD
Second Line : SUITE 130
City : MORGANTOWN
State : WV
Zip : 26501-6734
Country : US
Telephone Number : 304-291-3627
Fax Number : 304-284-3630
Authorized Official
Title or Position : VP OF PAYOR CONTRACTING
Name : TIMOTHY BUGIN
Credential :
Telephone Number : 304-225-2500
Provider Enumeration Date : 07/20/2005
Last Update Date : 02/14/2012

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1770749913 — PEGGY LEE FERGUSON CRNP
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1962772111 — MEDEXPRESS URGENT CARE, INC - WEST VIRGINIA
Practice Location Address:
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26501-6734
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Practice Fax: 304-284-8667

Directions to “MEDEXPRESS URGENT CARE PLLC-MORGANTOWN ” Practice Location

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