Pediatric Associate

NPI #1104937416 in Bridgeport, West Virginia

Provider Information

NPI Number: 1104937416
Entity Type: Organization
Organization Name: Pediatric Associate
Primary Specialty: Legal Medicine
Enumeration Date: Aug 31, 2006
Last Updated: Aug 22, 2020

Practice Location

Address: 11 CHENOWETH DR
Address 2: SUITE A
City: Bridgeport
State: West Virginia
ZIP Code: 26330-1675
Phone: (304) 842-5777

Authorized Official

Name: JOSEPH MOMEN, M.D.
Title: OWNER
Phone: (304) 842-5777

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Legal Medicine	173000000X	Primary

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