Individual
ANDREW KENNETH ETZEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
2115 CHAPLINE ST, WHEELING, WV 26003-3859
(304) 234-8885
Mailing address
109 MOUNT WOOD RD, WHEELING, WV 26003-2632
(304) 234-2455
(304) 233-6073
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
2251
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2967768
—
OH
05
—
3810015261
—
WV
01
—
P00960914
RAILROAD MEDICARE PIN
WV
Enumeration date
06/09/2009
Last updated
08/12/2013
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