Provider Demographics
NPI:1386026888
Name:WMC PHYSICIAN PRACTICES LLC
Entity Type:Organization
Organization Name:WMC PHYSICIAN PRACTICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AR COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:MARY SUE
Authorized Official - Middle Name:
Authorized Official - Last Name:WINLAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-797-6557
Mailing Address - Street 1:651 COLLIERS WAY STE 300
Mailing Address - Street 2:
Mailing Address - City:WEIRTON
Mailing Address - State:WV
Mailing Address - Zip Code:26062-5058
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:400 MARKET PLACE DR
Practice Address - Street 2:
Practice Address - City:OAKDALE
Practice Address - State:PA
Practice Address - Zip Code:15071-4007
Practice Address - Country:US
Practice Address - Phone:304-723-3355
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-22
Last Update Date:2015-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty