Organization · Type 2 NPI
Main Street Addiction Center Inc
Addiction Medicine (Family Medicine) Physician · Logan, WV
NPI number
1639616006
Active
Practice location
204 Main St
Logan, WV 25601-3944
Fax (304) 752-3400
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Addiction Medicine (Family Medicine) Physician Primary | 207QA0401X | 1489 (WV) |
Addiction Medicine (Family Medicine) Physician: A family medicine physician who specializes in the diagnosis and treatment of addictions.
Other addiction medicine (family medicine) physician providers in Logan
About NPI 1639616006
Main Street Addiction Center Inc's National Provider Identifier is 1639616006, issued on Jan 24, 2017. The primary taxonomy on file is Addiction Medicine (Family Medicine) Physician (207QA0401X), and the practice location is in Logan, WV. The record was last updated on Jan 24, 2017.