Judy, David

Judy, David is an sole proprietor health care provider with primary practice located at 4610 Kanawha Ave Sw Suite 302, Charleston WV 25309-1320. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Dermatology, Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery. Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery is his primary health care specialty. Judy, David can be contacted via phone (304) 925-7546.

Contact Information

Primary practice address
4610 Kanawha Ave Sw Suite 302 Charleston WV 25309-1320
Phone: (304) 925-7546
Fax: (681) 205-8369
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatology 207N00000X 2007-00740 North Carolina
Allopathic & Osteopathic Physicians / Dermatology 207N00000X OS 11120 Florida
Allopathic & Osteopathic Physicians / Dermatology 207N00000X 2596 West Virginia
Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery 207ND0101X 2596 West Virginia

Profile Details

NPI number 1619144433
LBN Legal business name Judy, David
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 12th, 2008
Last updated Oct 20th, 2014 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1619144433 NPPES
West Virginia MEDICAID 3810023193
West Virginia Other 5679351
West Virginia Other 1619144433
West Virginia Other 1619144433
West Virginia Other 1619144433
West Virginia Other 1619144433
West Virginia Other 2707397

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