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Contact Information

MOUNTAIN STATE MEDICINE AND RHEUMATOLOGY PLLC
1120 KANAWHA BLVD E STE 200
CHARLESTON, WV25301-2400
 Phone: 304-400-4900
 Fax: 304-400-4907
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Internal Medicine

207R00000X 11 Physician/Internal Medicine
 

Family

363LF0000X 50 Nurse Practitioner
 

Non-Pharmacy Dispensing Site

332900000X 87 All Other Suppliers
 

Nurse Practitioner

363L00000X 50 Nurse Practitioner
 

Rheumatology

207RR0500X 11 Physician/Internal Medicine
 

Specialist

174400000X
Indicates primary specialty

NPI Profile & details for MOUNTAIN STATE MEDICINE AND RHEUMATOLOGY PLLC · (Female)

NPI # 1982720801
Status Active
Credentials
Entity Individual
Enumeration date 03/22/2007
Last updated 01/12/2026 - About 5 months ago
Sole proprietor 1 Not specified
Identifiers
  • WV License # 1767
  • WV License # 1818
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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