Basic Information
| Provider Information | |||||||||
| NPI: | 1942367982 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WEBSTER | ||||||||
| FirstName: | ELLA | ||||||||
| MiddleName: | M | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1 MEDICAL CENTER DR | ||||||||
| Address2: | |||||||||
| City: | MORGANTOWN | ||||||||
| State: | WV | ||||||||
| PostalCode: | 265061200 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3045984000 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 600 SUNCREST TOWN CENTRE DR | ||||||||
| Address2: | |||||||||
| City: | MORGANTOWN | ||||||||
| State: | WV | ||||||||
| PostalCode: | 26505 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3045984478 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/02/2007 | ||||||||
| LastUpdateDate: | 10/17/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/15/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | MD30708 | DC | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | 0101056970 | VA | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RR0500X | 28551 | WV | N | Allopathic & Osteopathic Physicians | Internal Medicine | Rheumatology | 207RR0500X | 01086095A | IN | N | Allopathic & Osteopathic Physicians | Internal Medicine | Rheumatology | 207RR0500X | D0052886 | MD | N | Allopathic & Osteopathic Physicians | Internal Medicine | Rheumatology | 207RR0500X | ME129717 | FL | N | Allopathic & Osteopathic Physicians | Internal Medicine | Rheumatology | 207RR0500X | 21566 | MS | N | Allopathic & Osteopathic Physicians | Internal Medicine | Rheumatology | 207RR0500X | MD041737L | PA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Rheumatology |
ID Information
| ID | Type | State | Issuer | Description | 4C7XX | 01 | FL | FLORIDA BLUE | OTHER |