Individual
AMY ANNE VASILAKIS-DONZELLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
1315 MT. DECHANTAL ROAD, WHEELING, WV 26003-6392
(304) 243-7117
Mailing address
1315 MT. DECHANTAL ROAD, WHEELING, WV 26003-6392
(304) 243-7117
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
1899
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001718181
MOUNTAIN STATE BCBS
—
05
—
1809463000
—
WV
01
—
1899
HEALTH PLAN OF UPPER OH V
—
01
—
21502391100
OHIO BWC
OH
05
—
2410064
—
OH
01
—
55035705700
WV COMPENSATION
WV
Enumeration date
08/30/2005
Last updated
09/02/2015
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