NPI 1417917899

Phillip Nicodemus, CRNA

Practitioner Anesthesiology Physician Martinsburg, WV

Practice location

Address: 94 Old Mill Rd, Martinsburg, WV 25401-9284
Phone: (304) 264-8933
Fax: (304) 264-8846

Registered specialties

Anesthesiology Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207L00000X Licence 33379 (WV)

Other Anesthesiology providers in West Virginia →

Registry record

NPI: 1417917899
Entity type: Individual
Sex (as registered): Male
NPI issued: 28 Mar 2006
Record last updated: 13 Jul 2026

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.