Individual
DR. DAVID MICHAEL LIFE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
147 WILLOW TREE WAY, HURRICANE, WV 25526-1085
(304) 397-3002
(304) 397-3007
Mailing address
PO BOX 4190, BARBOURSVILLE, WV 25504-4190
(304) 399-4405
(304) 399-2526
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
17526
WV
207Q00000X
Family Medicine Physician
Primary
17526
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0054842-000
—
WV
01
—
P00138935
RAILROAD MEDICARE
—
Enumeration date
04/13/2006
Last updated
04/22/2021
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