Individual
DR. MICHAEL A WANCHICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
600 18TH ST, SUITE 202, PARKERSBURG, WV 26101-3231
(304) 424-4266
(304) 424-4490
Mailing address
600 18TH ST, SUITE 202, PARKERSBURG, WV 26101-3231
(304) 424-4266
(304) 424-4490
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
10118
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0096594000
—
WV
05
—
0263718
—
OH
Enumeration date
12/21/2005
Last updated
05/05/2008
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