NPI 1104794239

West Virginia University Medical Corporation

Organisation Orthopaedic Surgery Physician Charles Town, WV

Practice location

Address: 912 Somerset Blvd, Charles Town, WV 25414-3953
Phone: (304) 598-4830
Mailing address: PO Box 780, Morgantown, WV 26507-0780

Authorised official

Name: Justin Gibson
Title: Vp of Finance
Phone: (304) 598-4256

Registered specialties (3)

Orthopaedic Surgery Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207X00000X

Other Orthopaedic Surgery providers in West Virginia →

Pediatric Orthopaedic Surgery Physician

Allopathic & Osteopathic Physicians Taxonomy 207XP3100X

Physician Assistant

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363A00000X

Other Physician Assistant providers in West Virginia →

Registry record

NPI: 1104794239
Entity type: Organization
NPI issued: 29 Oct 2025
Record last updated: 29 Oct 2025

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.