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Individual

DR. DAVID WILLIAM GOETZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1063 MAPLE DR, SUITE 1A, MORGANTOWN, WV 26505-2848
(304) 598-2992
(304) 598-5901
Mailing address
100 AVERY OLIVIA WAY, SUITE C, FAIRMONT, WV 26554-9375
(304) 363-7000
(304) 366-7413

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
207K00000X
Allergy & Immunology Physician
NA
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0070421000
WV
Enumeration date
06/08/2005
Last updated
02/04/2010
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