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Individual
BRIAN WAYNE MACAULAY
Active
Individual
BRIAN WAYNE MACAULAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
14811
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001718160
MOUNTAIN STATE BCBS
—
05
—
0052239000
—
WV
01
—
14811
HEALTH PLAN OF UPPER OH V
—
05
—
2043621
—
OH
01
—
55035705700
WV COMPENSATION
WV
Enumeration date
08/09/2005
Last updated
07/18/2018
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