Provider Demographics
NPI:1316943756
Name:HUBER, KIRSTEN (MD)
Entity type:Individual
Prefix:
First Name:KIRSTEN
Middle Name:
Last Name:HUBER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 927
Mailing Address - Street 2:5 E. ALVON ROAD, SUITE 7
Mailing Address - City:WHITE SULPHUR SPRINGS
Mailing Address - State:WV
Mailing Address - Zip Code:24986-2373
Mailing Address - Country:US
Mailing Address - Phone:304-536-5030
Mailing Address - Fax:304-536-5031
Practice Address - Street 1:800 OAK ST
Practice Address - Street 2:
Practice Address - City:FARMVILLE
Practice Address - State:VA
Practice Address - Zip Code:23901-1199
Practice Address - Country:US
Practice Address - Phone:434-315-2998
Practice Address - Fax:434-392-7654
Is Sole Proprietor?:No
Enumeration Date:2005-06-21
Last Update Date:2011-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101058593208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA10029132OtherOPTIMA/SENTARA
VA61459600OtherBLACK LUNG/FECA
VA345613OtherANTHEM BCBS (FARMVILLE)
VA1316943756Medicaid
VA7127278OtherAETNA
VA2568995OtherCIGNA
VA345613OtherANTHEM BCBS (FARMVILLE)
H44507Medicare UPIN
VA010076170Medicare ID - Type Unspecified
VA004654S53Medicare ID - Type Unspecified
VAP00623311Medicare PIN