Stooke, Kim M

Stooke, Kim M is an individual health care provider with primary practice located at 800 Grand Central Mall Suite 4, Vienna WV 26105-4131. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Stooke, Kim M can be contacted via phone (304) 485-3300.

Contact Information

Primary practice address
800 Grand Central Mall Suite 4 Vienna WV 26105-4131
Phone: (304) 485-3300
Fax: (304) 485-3317
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 35.088838 Ohio
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 18455 West Virginia

Profile Details

NPI number 1922001767
LBN Legal business name Stooke, Kim M
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 24th, 2005
Last updated Sep 15th, 2022 - about 3 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1922001767 NPPES
West Virginia MEDICAID 0046995000
West Virginia MEDICAID 2045405

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