Individual
MICHELLE LYNN FOX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
407 WHEELING AVE, GLEN DALE, WV 26038-1536
(304) 845-1500
Mailing address
PO BOX 763, MORGANTOWN, WV 26507-0763
(800) 541-4009
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
20824
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001716693
BC BS
WV
01
—
186136
CARELINK
WV
05
—
2003105000
—
WV
01
—
20824
HEALTH PLAN
WV
01
—
2179887
FIRST HEALTH
WV
01
—
2335486
OHIO MEDICAID
WV
01
—
236944199
TRICARE
WV
01
—
383653649-001
MEDICAL MUTUAL
WV
01
—
5204621-004
CIGNA
WV
01
—
5445975
CCN
WV
01
—
897797
MAMSI
WV
Enumeration date
09/30/2005
Last updated
04/18/2022
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