Individual
DANIEL J DEFEO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1 STADIUM DRIVE, MORGANTOWN, WV 26506
(304) 598-4800
(304) 293-6702
Mailing address
PO BOX 897, MORGANTOWN, WV 26507-0897
(304) 293-7401
(304) 293-6963
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
36585
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7102294000
—
WV
Enumeration date
10/23/2006
Last updated
11/23/2010
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