Individual
BRIAN WAYNE MACAULAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
116 HILLS PLZ, CHARLESTON, WV 25387-2438
(304) 720-4466
(304) 720-4815
Mailing address
1602 HARPER RD, BECKLEY, WV 25801-3310
(304) 757-6999
(304) 757-3252
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
14811
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001718160
MOUNTAIN STATE BCBS
—
05
—
0052239000
—
WV
01
—
14811
HEALTH PLAN OF UPPER OH V
—
05
—
2043621
—
OH
01
—
55035705700
WV COMPENSATION
WV
Enumeration date
08/09/2005
Last updated
07/18/2018
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