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NPI Code Detail

MEDICARE: DR. CHRISTINE A. BANVARD-FOX M.D.

MEDICARE: DR. CHRISTINE A. BANVARD-FOX M.D.
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
12080A0000XPediatric Adolescent Medicine Physician16084WV

General Provider Information

NPI Number : 1356548630
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CHRISTINE A. BANVARD-FOX M.D.
Provider Business Mailing Address
First Line : 9247 STUDENT HEALTH SERVICE
Second Line : ROBERT C. BYRD HEALTH SCIENCES CENTER
City : MORGANTOWN
State : WV
Zip : 26506-9247
Country : US
Telephone Number : 304-293-2311
Fax Number : 304-293-2713
Provider Business Practice Location Address
First Line : 6040 UNIVERSITY TOWN CENTRE DR
Second Line :
City : MORGANTOWN
State : WV
Zip : 26501-2421
Country : US
Telephone Number : 855-988-2273
Fax Number : 304-285-7388
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/29/2007
Last Update Date : 03/08/2023

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