| Genesis Elder Care Physician Services Llc | |
|
161 Bakers Ridge Rd Morgantown WV 26508-1459 | |
| (304) 285-0692 | |
| Not Available |
| Full Name | Genesis Elder Care Physician Services Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 161 Bakers Ridge Rd, Morgantown, West Virginia |
| Authorized Official Name and Position | Eric Shapiro (VP, CONTROLLER) |
| Authorized Official Contact | 4108327790 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Genesis Elder Care Physician Services Llc Po Box 42738 Towson MD 21284-2738 Ph: (410) 494-7607 | Genesis Elder Care Physician Services Llc 161 Bakers Ridge Rd Morgantown WV 26508-1459 Ph: (304) 285-0692 |
| NPI Number | 1285653451 |
|---|---|
| Provider Enumeration Date | 07/19/2006 |
| Last Update Date | 04/13/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285653451 | NPI | - | NPPES |
| 3810001777 | Medicaid | WV |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
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