Provider Demographics
NPI:1477623775
Name:GUYER, GRETA VIRGINIA (MD)
Entity Type:Individual
Prefix:
First Name:GRETA
Middle Name:VIRGINIA
Last Name:GUYER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:GRETA
Other - Middle Name:VIRGINIA
Other - Last Name:FLANAGAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4605 MACCORKLE AVE SW
Mailing Address - Street 2:THS PHYSICIAN PARTNERS, INC. - ADMIN OFC
Mailing Address - City:SOUTH CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25309-1311
Mailing Address - Country:US
Mailing Address - Phone:304-414-4800
Mailing Address - Fax:304-414-4801
Practice Address - Street 1:500 POPLAR ST
Practice Address - Street 2:SUITE 202
Practice Address - City:SOUTH CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25309-1474
Practice Address - Country:US
Practice Address - Phone:304-346-2121
Practice Address - Fax:304-346-2176
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2021-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV16889207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0078273000Medicaid
WV3810024049OtherGROUP MEDICAID
WVB441OtherGROUP MEDICARE
WVWV3169B441Medicare PIN