| Randy L Warren Md Pllc | |
|
4501 Maccorkle Ave Sw Suite 202 Charleston WV 25309-1444 | |
| (304) 766-6666 | |
| (304) 766-0999 |
| Full Name | Randy L Warren Md Pllc |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 4501 Maccorkle Ave Sw, Charleston, West Virginia |
| Authorized Official Name and Position | Randy L Warren (OWNER/MEMBER) |
| Authorized Official Contact | 3047666666 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Randy L Warren Md Pllc 4501 Maccorkle Ave Sw Suite 202 Charleston WV 25309-1444 Ph: (304) 766-6666 | Randy L Warren Md Pllc 4501 Maccorkle Ave Sw Suite 202 Charleston WV 25309-1444 Ph: (304) 766-6666 |
| NPI Number | 1053583575 |
|---|---|
| Provider Enumeration Date | 03/25/2008 |
| Last Update Date | 03/25/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053583575 | NPI | - | NPPES |
| 3810002129 | Medicaid | WV |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 21827 (West Virginia) | Primary |
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