Provider Demographics
NPI:1538433891
Name:MICHAEL CORBIN M.D INC
Entity type:Organization
Organization Name:MICHAEL CORBIN M.D INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:A/R COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:LEIGH
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:GARDNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-675-1020
Mailing Address - Street 1:2520 VALLEY DRIVE
Mailing Address - Street 2:SUITE 215
Mailing Address - City:PT PLEASANT
Mailing Address - State:WV
Mailing Address - Zip Code:25550
Mailing Address - Country:US
Mailing Address - Phone:304-675-2229
Mailing Address - Fax:304-675-5068
Practice Address - Street 1:2520 VALLEY DRIVE
Practice Address - Street 2:SUITE 215
Practice Address - City:PT PLEASANT
Practice Address - State:WV
Practice Address - Zip Code:25550
Practice Address - Country:US
Practice Address - Phone:304-675-2229
Practice Address - Fax:304-675-5068
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-05
Last Update Date:2013-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV19349207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty