LAWRENCE BLAIR THRUSH MD

Allergy and Immunology

Charleston, West Virginia

Provider NPI: 1356333405

Provider Information:
 LAWRENCE BLAIR THRUSH MD


Practice Location:
3411A NOYES AVE SE  CHARLESTON, WV 25304 US
Tel: 304-344-2459  Fax: --

Business Mailing Address:
  ,   
Tel: --  Fax: --


Taxonomy:

Primary	Code	Category/Description	State	License Number
N	207KA0200X	Physicians Allergy & Immunology Allergy	WV	11974
Y	207K00000X	Physicians Allergy & Immunology	WV	11974

Other Provider Identifiers:

Issuer	Number	State	Type
BCBS	000113916	WV	01
	0070499000	WV	05
AETNA	4252011	WV	01

Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin

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