MEDICARE: WEST VIRGINIA GYNECOLOGIC ONCOLOGY ASSOC LLC

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
1	207VX0201X	Gynecologic Oncology Physician	18239	WV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	18239	OTHER	WV	STATE LICENSE

General Provider Information

NPI Number	:	1851514830
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WEST VIRGINIA GYNECOLOGIC ONCOLOGY ASSOC LLC

Provider Business Mailing Address
First Line	:	1 COURTNEY DR
Second Line	:
City	:	CHARLESTON
State	:	WV
Zip	:	25304-2696
Country	:	US
Telephone Number	:	304-925-4200
Fax Number	:

Provider Business Practice Location Address
First Line	:	1 COURTNEY DR
Second Line	:
City	:	CHARLESTON
State	:	WV
Zip	:	25304-2696
Country	:	US
Telephone Number	:	304-925-4200
Fax Number	:	304-925-0484

Authorized Official
Title or Position	:	OWNER
Name	:	MICHAEL A SCHIANO
Credential	:	MD
Telephone Number	:	304-925-4200

Provider Enumeration Date	:	04/10/2007
Last Update Date	:	05/14/2013

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