Crystal Bastin MD LLC
NPI #1053539387 in South Charleston, West Virginia
Provider Information
- NPI Number
- 1053539387
- Entity Type
- Organization
- Organization Name
- Crystal Bastin MD LLC
- Primary Specialty
- Family Medicine
- Enumeration Date
- Apr 23, 2007
- Last Updated
- Nov 12, 2013
Practice Location
- Address
- 4820 KENTUCKY ST
- City
- South Charleston
- State
- West Virginia
- ZIP Code
- 25309-1310
- Phone
- (304) 720-0390
Authorized Official
- Name
- SHANNON G DAVIS
- Title
- OFFICE MANAGER
- Phone
- (304) 720-0390
Specialties & Taxonomy Codes
| Specialty |
|---|
| Family Medicine |
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