Unknown Individual – Family Medicine Physician, NPI 1336498278
Family Medicine Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for Unknown Individual
342 TWP RD 1539
PROCTORVILLE, OH 456699210
Phone:
Type: Mailing
1448 10TH AVE
EBENEEZER MEDICAL OUTREACH
HUNTINGTON, WV 25701
Phone: (304) 529-0753
Fax: (304) 529-0591
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
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Medicare Enrollment & Revalidation
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No Medicare enrollment or revalidation data available for this provider in our database.
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Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
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No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 45669)
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