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Charleston Medical Center, Inc. — NPI 1174479513, Fayetteville, WV | NPI Central

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NPI 1174479513

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Charleston Medical Center, Inc.

NPI 1174479513 · Otolaryngology Physician · Fayetteville, WV

Provider details

NPI number: 1174479513
Entity type: Organization
Primary specialty: Otolaryngology PhysicianAllopathic & Osteopathic Physicians
Organization subpart: No
Authorized official: Ginger Peters, Payer Enrollment Representative(304) 388-0112

Specialties & taxonomies

Otolaryngology PhysicianPrimary207Y00000X
Allopathic & Osteopathic Physicians
Audiologist231H00000X
Speech, Language and Hearing Service Providers
Surgery Physician208600000X
Allopathic & Osteopathic Physicians

Practice location

211 W Maple Ave

Fayetteville, WV 25840-1445

Phone: (304) 900-5511

Approximate (ZIP-level) locationGet directions

More WV providers

Mailing address

211 W Maple Ave

Fayetteville, WV 25840-1445

Other names (DBA / former)

Other name: Camc Pmc Specialty Clinics

Registry dates

Enumerated: 2026-03-09
Last updated: 2026-03-09
Certified: 2026-03-09

Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.