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Contact Information

MARTINSBURG INTERNAL MEDICINE ASSOC INC
1002 SUSHRUTA DRIVE
MARTINSBURG, WV25401
 Phone: 304-263-0913
 Fax: 304-267-2917
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical Medical Laboratory

291U00000X 69 Clinical Laboratory
Indicates primary specialty

NPI Profile & details for MARTINSBURG INTERNAL MEDICINE ASSOC INC

NPI # 1689735565
LBN Legal business name MARTINSBURG INTERNAL MEDICINE ASSOC INC
Authorized official JESSE JALAZO - (PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 12/13/2006
Last updated 08/22/2020 - About 6 years ago
Identifiers
WV Medicaid 0008030001
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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