Individual
MR. CHARLES WESLEY WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
113 DEERFIELD LN, FAYETTEVILLE, WV 25840-6799
(304) 890-1167
Mailing address
113 DEERFIELD LN, FAYETTEVILLE, WV 25840-6799
(304) 890-1167
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
01/05/2023
Last updated
07/02/2025
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