Individual
DR. RICHARD E VASICEK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
177 MIDDLETOWN RD STE 1, FAIRMONT, WV 26554-8254
(304) 363-6600
Mailing address
PO BOX 763, MORGANTOWN, WV 26507-0763
(800) 541-4009
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
1552
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000558950
BC
—
01
—
0010879001
MCAID WM LAB
WV
05
—
0047267000
—
WV
Enumeration date
10/13/2006
Last updated
09/19/2022
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