Individual
ROGER MCDANIEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN-CNP
Contact information
Practice address
1 MEDICAL CENTER DR., CLARKSBURG, WV 26301
(304) 623-3461
Mailing address
1 MEDICAL CENTER DRIVE, CLARKSBURG, WV 26301
(304) 623-3461
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
114667
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
114677
LICENSE NUMBER
WV
Enumeration date
01/06/2023
Last updated
01/06/2023
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