Provider Demographics
NPI:1174040265
Name:CHARLESTON AREA MEDICAL CENTER INC
Entity Type:Organization
Organization Name:CHARLESTON AREA MEDICAL CENTER INC
Other - Org Name:CAMC CARDIOLOGY SOUTH CHARLESTON
Other - Org Type:Other Name
Authorized Official - Title/Position:VICE PRESIDENT - FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:Z
Authorized Official - Last Name:BELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-388-6251
Mailing Address - Street 1:3100 MACCORKLE AVE SE STE 203
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25304-1228
Mailing Address - Country:US
Mailing Address - Phone:304-388-1724
Mailing Address - Fax:304-388-1721
Practice Address - Street 1:4610 KANAWHA AVE SW STE 200
Practice Address - Street 2:
Practice Address - City:SOUTH CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25309-1367
Practice Address - Country:US
Practice Address - Phone:304-205-7992
Practice Address - Fax:304-205-7739
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-29
Last Update Date:2017-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV1035-7147207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty