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Individual
CURTIS BRENT PACK
Active
Individual
CURTIS BRENT PACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
1450
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001721667
BCBS
WV
05
—
0046893000
—
WV
05
—
0245176
—
OH
01
—
385750
FEDERAL BLACK LUNG
WV
01
—
550737600
AETNA
WA
01
—
550737600
COMMERICAL INSURANCE
WV
Enumeration date
09/21/2006
Last updated
10/15/2019
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