Blue Lot MD Pllc
NPI #1104559160 in Charleston, West Virginia
Provider Information
- NPI Number
- 1104559160
- Entity Type
- Organization
- Organization Name
- Blue Lot MD Pllc
- Subpart
- Yes (part of a larger organization)
- Parent Organization
- BLUE LOT MD PLLC
- Primary Specialty
- Internal Medicine
- Enumeration Date
- Jul 7, 2022
- Last Updated
- Aug 4, 2022
Practice Location
- Address
- 10 COURTNEY DR
- City
- Charleston
- State
- West Virginia
- ZIP Code
- 25304-2699
- Phone
- (304) 344-2345
Authorized Official
- Name
- DR. LETITIA ELAINE TIERNEY, MD
- Title
- SOLE MEMBER
- Phone
- (304) 344-2345
Specialties & Taxonomy Codes
| Specialty |
|---|
| Internal Medicine |
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