Provider Demographics
NPI:1568548485
Name:ARBOR MEDICAL ASSOCIATES, PLLC
Entity Type:Organization
Organization Name:ARBOR MEDICAL ASSOCIATES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PEDIATRICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LORRIE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:DOWNS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:304-637-3565
Mailing Address - Street 1:105 NATHAN ST
Mailing Address - Street 2:
Mailing Address - City:ELKINS
Mailing Address - State:WV
Mailing Address - Zip Code:26241-3331
Mailing Address - Country:US
Mailing Address - Phone:304-636-0133
Mailing Address - Fax:304-637-3568
Practice Address - Street 1:105 NATHAN ST
Practice Address - Street 2:
Practice Address - City:ELKINS
Practice Address - State:WV
Practice Address - Zip Code:26241-3331
Practice Address - Country:US
Practice Address - Phone:304-636-0133
Practice Address - Fax:304-637-3568
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-31
Last Update Date:2009-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV3810001015Medicaid
WVI7359Medicare UPIN
WVANNP19021Medicare ID - Type UnspecifiedGROUP MEDICARE # ID
WVD09347571Medicare ID - Type UnspecifiedGROUP MEDICARE ID #
WV3810001015Medicaid
WVQ51529Medicare UPIN