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Individual

DR. MATHEW W LIVELY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M. D.

Contact information

Practice address
2195 CHEAT RD STE 2, MORGANTOWN, WV 26508-4516
(304) 594-0456
(304) 594-3249
Mailing address
2195 CHEAT RD STE 2, MORGANTOWN, WV 26508-4516
(304) 594-0456
(304) 594-3249

Taxonomy

Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
Primary
1445
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0048724000
WV
Enumeration date
08/17/2006
Last updated
04/02/2018
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