NPI 1417782244

Evernorth Care Providers - Delaware PA

Organisation General Practice Physician Charleston, WV

Practice location

Address: 232 Capitol St STE 2a, Charleston, WV 25301-2234
Phone: (773) 292-4800
Fax: (312) 564-4059
Mailing address: 730 Cool Springs Blvd STE 500, Franklin, TN 37067-7331

Authorised official

Name: Grace Blue
Title: Credentialing Sr. Manager
Phone: (773) 292-4800

Registered specialties

General Practice Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 208D00000X

Other General Practice providers in West Virginia →

Registry record

NPI: 1417782244
Entity type: Organization
NPI issued: 3 Sep 2024
Record last updated: 3 Sep 2024

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.