Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207SG0201X | Clinical Genetics (M.D.) | 14824 | WV |
N | 208000000X | Pediatrician | 14824 | WV |
NPI | 1144337684 |
---|---|
Provider Name | Dr. Marybeth Hummel |
First Address | Morgantown, WV 26507-0897 |
Second Address | Morgantown, WV 26506 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/08/2006 |
Last Update Date | 22/10/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0104808000 | (05) | WV |
B42796 | (02) | WV |