Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Crystal Bastin MD LLC

Organization Family Medicine Physician · NPI 1053539387

Crystal Bastin MD LLC is a Family Medicine Physician in South Charleston, West Virginia. Licensed in West Virginia. Registered with an NPI since 2007.

Licensed in
WV
In the registry since
2007
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

4820 Kentucky St
South Charleston, WV 25309-1310
Phone: (304) 720-0390
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 20368 (WV)

Record details

NPI number1053539387
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Shannon Davis — Office Manager · (304) 720-0390
NPI enumeratedApril 23, 2007
Last updated in NPPESNovember 12, 2013
Mailing address4820 Kentucky Street, South Charleston, WV 25309-1364

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