Lakeside Family Practice Pllc

NPI 1205919917 - Family Medicine - 207Q00000X

NPI Details
NPI 1205919917
Enumeration Date 10/24/2006
Last Updated 05/09/2011
Entity Type Healthcare Provider
Active Over 10 years ago
Authorized Information
Name BRIAN W BRIAN
Position PRESIDENT
Phone (304) 594-2400
Fax (304) 594-2256
Practice Location
933 CHEAT RD
MORGANTOWN WV, 26508-5631, US
Phone (304) 594-2400
Fax (304) 594-2256
Business Location
933 CHEAT RD
MORGANTOWN WV, 26508-5631, US
Phone (304) 594-2400
Fax (304) 594-2256
Toxanomy
Taxonomy Code 207Q00000X
License State
License Number
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According to our database, Lakeside Family Practice Pllc NPI is 1205919917, taxonomy code is 207Q00000X Lakeside Family Practice Pllc physically located at 933 Cheat Rd, Morgantown WV, 26508-5631. NPI Number 1033115704 has the healthcare provider type.

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1205919917 NPI number is provided on an as is basis without warranty of any kind. 1205919917 is maintained by the National Plan & Provider Enumeration System. The contents of Lakeside Family Practice Pllc are for informational purposes only.