Crystal Bastin Md Llc - Primary Care in South Charleston, WV

Crystal Bastin Md Llc is a primary clinic (Family Medicine) in South Charleston, West Virginia. The current practice location for Crystal Bastin Md Llc is 4820 Kentucky St, South Charleston, West Virginia. For appointments, you can reach them via phone at (304) 720-0390. The mailing address for Crystal Bastin Md Llc is 4820 Kentucky Street, South Charleston, West Virginia and phone number is (304) 720-0390.

Crystal Bastin Md Llc is licensed to practice in West Virginia (license number 20368) and its NPI number is 1053539387. This medical practice does not participate in medicare program and thus may not accept your medicare insurance. You may check if they accept your insurance at (304) 720-0390.

Contact Information

Crystal Bastin Md Llc
4820 Kentucky St
South Charleston
WV 25309-1310
(304) 720-0390
Not Available

Primary Care Clinic Profile

Full NameCrystal Bastin Md Llc
SpecialityFamily Medicine
Location4820 Kentucky St, South Charleston, West Virginia
Authorized Official Name and PositionShannon G Davis (OFFICE MANAGER)
Authorized Official Contact3047200390
Accepts Medicare InsuranceThis clinic does not participate in Medicare Program.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Crystal Bastin Md Llc
4820 Kentucky Street
South Charleston
WV 25309-1364

Ph: (304) 720-0390
Crystal Bastin Md Llc
4820 Kentucky St
South Charleston
WV 25309-1310

Ph: (304) 720-0390

NPI Details:

NPI Number1053539387
Provider Enumeration Date04/23/2007
Last Update Date11/12/2013

Medical Identifiers

Medical identifiers for Crystal Bastin Md Llc such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1053539387NPI-NPPES
1801865001MedicaidWV

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207Q00000XFamily Medicine 20368 (West Virginia)Primary

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