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Contact Information

COLLABORATIVE GERIATRICS, INC.
414 MAHOGANYWOOD DR
MILTON, WV25541-1181
 Phone: 304-743-8007
 Fax: 304-743-1704
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Geriatric Medicine

207QG0300X 08 Physician/Family Practice
Indicates primary specialty

NPI Profile & details for COLLABORATIVE GERIATRICS INC · (Female)

NPI # 1629004221
Status Active
Credentials
Entity Individual
Enumeration date 06/24/2006
Last updated 08/22/2020 - About 6 years ago
Sole proprietor 1 Not specified
Identifiers
  • WV License # 14713
  • WV License # 1601
  • WV License # 20005
  • WV License # 21327
  • WV Medicaid 0040807000
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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