1417371329 NPI number — UNIVERSITY HEALTHCARE PHYSICIANS INC

Table of content: DR. GOLDA SOL MADARANG FERNANDEZ MD (NPI 1144531625)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1417371329 NPI number — UNIVERSITY HEALTHCARE PHYSICIANS INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
UNIVERSITY HEALTHCARE PHYSICIANS INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
UHP ANESTHESIA
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1417371329
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/12/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
109 MOUNT WOOD RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WHEELING
Provider Business Mailing Address State Name:
WV
Provider Business Mailing Address Postal Code:
26003-2632
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
304-233-2455
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2500 FOUNDATION WAY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MARTINSBURG
Provider Business Practice Location Address State Name:
WV
Provider Business Practice Location Address Postal Code:
25401-9000
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
304-264-9202
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/12/2014

Additional Information

Authorized Official

Authorized Official Last Name:
NAU
Authorized Official First Name:
KONRAD
Authorized Official Middle Name:
C
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
304-264-9202

Provider Taxonomy Codes

  • Taxonomy code: 207L00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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