Organization
MICHAEL FAMILY PRACTICE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AMANDA G MICHAEL D.O. (PHYSICIAN)
(304) 258-8824
Entity
Organization
Contact information
Practice address
2055 VALLEY ROAD, BERKELEY SPRINGS, WV 25411
(304) 258-8824
Mailing address
PO BOX 1111, BERKELEY SPRINGS, WV 25411-3111
(304) 258-8824
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2583
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2583
WEST VIRGINIA LICENSE
WV
01
—
3438686
CIGNA
WA
05
—
3810023434
—
WV
Enumeration date
02/10/2012
Last updated
10/13/2014
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