| Upmc Western Maryland Corporation | |
|
45 Hunt Club Dr Ridgeley WV 26753-7567 | |
| (304) 726-4501 | |
| (304) 726-4051 |
| Full Name | Upmc Western Maryland Corporation |
|---|---|
| Speciality | Clinic/Center |
| Location | 45 Hunt Club Dr, Ridgeley, West Virginia |
| Authorized Official Name and Position | Amber Ruble (CFO) |
| Authorized Official Contact | 2409648032 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Upmc Western Maryland Corporation 600 Grant Street, Us Steel Tower, 59th Floor C/o Renee Johnson Pittsburgh PA 15219-1671 Ph: (412) 623-6303 | Upmc Western Maryland Corporation 45 Hunt Club Dr Ridgeley WV 26753-7567 Ph: (304) 726-4501 |
| NPI Number | 1215558416 |
|---|---|
| Provider Enumeration Date | 04/29/2020 |
| Last Update Date | 06/13/2023 |
| Medicare PECOS PAC ID | 7113900655 |
|---|---|
| Medicare Enrollment ID | O20200609001290 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215558416 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| 261QU0200X | Clinic/center - Urgent Care | (* (Not Available)) | Secondary |
| Provider Name | Lynn Metcalf |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538444369 PECOS PAC ID: 8224293634 Enrollment ID: I20120710000782 |
| Provider Name | Rondal Nicole Zapf |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659709558 PECOS PAC ID: 8729210786 Enrollment ID: I20160606001061 |
| Provider Name | Amit S Kalaria |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1578510897 PECOS PAC ID: 4183652936 Enrollment ID: I20161031001858 |
| Provider Name | Rebekah J Haywood |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942672704 PECOS PAC ID: 3072813492 Enrollment ID: I20170314001250 |
| Provider Name | Angelina Musselman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851780365 PECOS PAC ID: 2860713443 Enrollment ID: I20180209001452 |
| Provider Name | Nicole Bonner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770733248 PECOS PAC ID: 1456538297 Enrollment ID: I20190612002274 |
| Provider Name | Jeremy Steward |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346769742 PECOS PAC ID: 7113285347 Enrollment ID: I20191021001200 |
| Provider Name | Ronald Clifford Kinsey |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1477580660 PECOS PAC ID: 4082647755 Enrollment ID: I20200717000262 |
| Provider Name | Robert Hallock |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1043265804 PECOS PAC ID: 3173521580 Enrollment ID: I20200720001121 |