Individual
DR. DAVID MONTGOMERY MCLELLAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1708 LOCUST AVE, SUITE 102, FAIRMONT, WV 26554-1332
(304) 363-5799
(304) 366-0346
Mailing address
1708 LOCUST AVE, SUITE 102, FAIRMONT, WV 26554-1332
(304) 363-5799
(304) 366-0346
Taxonomy
Speciality
Code
Description
License number
State
204D00000X
Neuromusculoskeletal Medicine & OMM Physician
Primary
13066
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0128367000
—
WV
Enumeration date
03/27/2007
Last updated
07/08/2007
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