Individual
RICKY L. HOUDERSHELDT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3705 TEAYS VALLEY RD, STE 202, HURRICANE, WV 25526-8757
(304) 757-6990
(304) 757-0912
Mailing address
3705 TEAYS VALLEY RD, STE 202, HURRICANE, WV 25526-8757
(304) 757-6990
(304) 757-0912
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
789
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001720446
BC
—
05
—
0084490000
—
WV
Enumeration date
05/22/2006
Last updated
06/18/2013
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