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Individual
MARIE B FEARON-JEWELL
Active
Individual
MARIE B FEARON-JEWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
0102201186
VA
207Q00000X
Family Medicine Physician
Primary
1749
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001717979
BLUE CROSS BLUE SHIELD
WV
05
—
010038251
—
VA
01
—
345878
ANTHEM
VA
01
—
P00466094
RAILROAD PTAN
WV
Enumeration date
01/17/2006
Last updated
02/27/2013
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