Individual
WESLEY R LIEVING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
2007 SECOND STREET, MASON, WV 25260
(304) 773-5194
Mailing address
2007 SECOND STREET, MASON, WV 25260
(304) 773-5194
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
2158
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
550737600
TAX IDENTIFICATION
WV
Enumeration date
07/23/2007
Last updated
07/23/2007
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