Provider Demographics
NPI:1437581733
Name:UNIVERSITY HEALTHCARE PHYSICIANS, INC.
Entity Type:Organization
Organization Name:UNIVERSITY HEALTHCARE PHYSICIANS, INC.
Other - Org Name:WVU URGENT CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:KONRAD
Authorized Official - Middle Name:C
Authorized Official - Last Name:NAU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:304-264-9202
Mailing Address - Street 1:2500 FOUNDATION WAY
Mailing Address - Street 2:
Mailing Address - City:MARTINSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:25401-9000
Mailing Address - Country:US
Mailing Address - Phone:304-264-9202
Mailing Address - Fax:304-264-9042
Practice Address - Street 1:5047 GERRARDSTOWN RD
Practice Address - Street 2:STE A
Practice Address - City:INWOOD
Practice Address - State:WV
Practice Address - Zip Code:25428-3951
Practice Address - Country:US
Practice Address - Phone:304-229-2273
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-08
Last Update Date:2013-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV207Q00000X, 261QU0200X, 291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
No291U00000XLaboratoriesClinical Medical Laboratory