West Virginia University Medical Corporation
NPI 1104674480 · Emergency Medicine Physician · Martinsburg, WV
Provider details
- NPI number
- 1104674480
- Entity type
- Organization
- Primary specialty
- Emergency Medicine PhysicianAllopathic & Osteopathic Physicians
- Parent organization
- West Virginia University Medical Corporation
- Organization subpart
- Yes
- Authorized official
- Justin Gibson, Vp, Finance(304) 598-4256
Specialties & taxonomies
Allopathic & Osteopathic Physicians
- Nurse Practitioner363L00000X
Physician Assistants & Advanced Practice Nursing Providers
- Family Medicine Physician207Q00000X
Allopathic & Osteopathic Physicians
- Physician Assistant363A00000X
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
2 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2024-05-10
- Last updated
- 2026-04-28
- Certified
- 2026-04-28
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.