Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 25811 | WV |
NPI | 1003179326 |
---|---|
Provider Name | Dr. Mollie Mccartney Cecil |
First Address | Kingwood, WV 26537 |
Second Address | Kingwood, WV 26537 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/06/2012 |
Last Update Date | 08/09/2015 |