MOUNTAIN STATE VASCULAR, INC.; NPI #1104318625

Contact Information

MOUNTAIN STATE VASCULAR, INC.

121 GEORGE STREET
BECKLEY, WV 25801

Phone: 304-250-0382
Fax:
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Vascular Surgery	2086S0129X	76	Physician/Peripheral Vascular Disease

Indicates primary specialty

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NPI Profile & details for MOUNTAIN STATE VASCULAR, INC.

NPI Number 1104318625

LBN Legal business name MOUNTAIN STATE VASCULAR, INC.

Authorized official BRIAN WHYTE - (OWNER)

Entity Organization

Organization subpart ¹ No

Enumeration date 05/31/2018

Last updated 05/22/2024 - About 2 years ago

Identifiers

WV	License #	22852
WV	Other	9ALVR	STATE OF WV CERTIFICATE
WV	Other	1795	WV BOARD OF MEDICINE REGISTRATION

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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MOUNTAIN STATE VASCULAR, INC.

Contact Information

Specialty

Vascular Surgery

NPI Profile & details for MOUNTAIN STATE VASCULAR, INC.

Reviews for MOUNTAIN STATE VASCULAR, INC.