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Individual

DR. MICHAEL E. ANTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1120 KANAWHA BLVD E, CHARLESTON, WV 25301-2400
(304) 344-3457
(304) 344-3480
Mailing address
PO BOX 11137, CHARLESTON, WV 25339-1137
(304) 344-3457
(304) 344-3480

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
21512
WV
2085R0202X
Diagnostic Radiology Physician
MC-203
GU

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
001718810
FREEDOM BLUE & MT ST BCBS
WV
01
0130753
UMWA
WV
01
020011800
FEDERAL BLACK LUNG
WV
05
14175
WV
01
14193
CARELINK & CARELINK PEIA
WV
01
151237200
US DOL & US POSTAL COMP
WV
05
2492253
OH
05
3810000056
WV
01
55-0516458
GROUP FEIN #
WV
01
550516458
ACORDIA NATIONAL PEIA
WV
05
550516458
WV
05
64080955
KY
01
I07407
BRICKSTREET INSURANCE
WV
Enumeration date
06/10/2005
Last updated
06/13/2024
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