Pediatric Associate
NPI #1538256805 in Bridgeport, West Virginia
Provider Information
- NPI Number
- 1538256805
- Entity Type
- Organization
- Organization Name
- Pediatric Associate
- Primary Specialty
- Clinical Medical Laboratory
- Enumeration Date
- Oct 6, 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
- MANZAR MOMEN, MD
- Title
- OFFICE MANAGER
- Phone
- (304) 842-5777
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinical Medical Laboratory |
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