Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
BRADDOCK MEDICAL GROUP P.A.
Active OrganizationBRADDOCK MEDICAL GROUP P.A. is a Adolescent Medicine organization located in FORT ASHBY, West Virginia. NPI 1104962729 is currently active in the NPPES registry. Verify at CMS.
Adolescent Medicine · FORT ASHBY, WV
Registration Details
- NPI Number
- 1104962729
- Provider Type
- Organization
- NPI Issued
- Jan 30, 2007 (19.350309680377 yrs)
- Last Updated
- Nov 1, 2016
- License
-
11172 (WV)
Practice Information
- Address
-
70 PRESIDENTS STREETUNIT 1150FORT ASHBY, WV, 267191150Browse WV providers · Browse ZIP 26719
- Phone
- 3042983605
- Fax
- 3042983578
- Primary Specialty
-
Adolescent Medicine
207QA0505X
Data sourced from the NPPES National Provider Identifier registry. Healthcare organizations registered in NPPES are assigned an NPI number for use in insurance billing and claims. This information is for informational purposes only. For official verification, use the NPPES NPI Registry.