Individual
DR. EYASSU G HAILEMICHAEL
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
101 STADIUM DR, MORGANTOWN, WV 26506-7911
(304) 598-4000
(304) 293-6963
Mailing address
PO BOX 897, MORGANTOWN, WV 26507-0897
(304) 293-7401
(304) 293-6963
Taxonomy
Speciality
Code
Description
License number
State
2085P0229X
Pediatric Radiology Physician
Primary
21807
WV
2085R0202X
Diagnostic Radiology Physician
21807
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810001765
—
WV
Enumeration date
03/23/2006
Last updated
09/11/2025
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