Proctor, Michael Douglas

Proctor, Michael Douglas is an individual health care provider with primary practice located at 4142 Taylors Ridge Rd , Proctor WV 26055-4241. He recently has only one registered license in Nursing Service Related Providers / Personal Care Attendant, which is considered as his primary health care specialty. Proctor, Michael Douglas can be contacted via phone (304) 842-9887.

Contact Information

Primary practice address
4142 Taylors Ridge Rd Proctor WV 26055-4241
Phone: (304) 842-9887
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Nursing Service Related Providers / Personal Care Attendant 3747P1801X

Profile Details

NPI number 1619740115
LBN Legal business name Proctor, Michael Douglas
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 6th, 2023
Last updated Nov 6th, 2023 - about last year

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 1619740115 NPPES
West Virginia MEDICAID 1821206228
West Virginia MEDICAID 1356607394
West Virginia MEDICAID 125553494

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