NPI 1104937416
Pediatric Associate
Practice location
- Address
- 11 Chenoweth Dr Suite a, Bridgeport, WV 26330-1675
- Phone
- (304) 842-5777
- Fax
- (304) 842-3318
Authorised official
- Name
- Joseph Momen
- Title
- Owner
- Phone
- (304) 842-5777
Registered specialties
Legal Medicine
Primary
Registry record
- NPI
- 1104937416
- Entity type
- Organization
- NPI issued
- 31 Aug 2006
- Record last updated
- 22 Aug 2020
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.