Gump, Stacie D
Gump, Stacie D is an individual health care provider with primary practice located at 2838 Pike Street Wvu Medicine Patriot Pointe Camden Clark Physici Corpor, Parkersburg WV 26101. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Gump, Stacie D can be contacted via phone (304) 865-5070.Contact Information
Primary practice address
2838 Pike Street Wvu Medicine Patriot Pointe Camden Clark Physici Corpor
Parkersburg WV 26101
Phone: (304) 865-5070
Fax: (304) 489-4250
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | D0060181 | Maryland |
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 25319 | West Virginia |
Profile Details
| NPI number | 1194717041 |
|---|---|
| LBN Legal business name | Gump, Stacie D |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 17th, 2005 |
| Last updated | Apr 18th, 2022 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1194717041 | NPPES |
| Maryland | MEDICAID | 402740000 |
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