Individual
JEFFERY F ADDISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
15775
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10010042
BRICKSTREET
WV
01
—
197254861
PEIA
—
01
—
1972548618
AETNA
—
01
—
2496080
OHIO JOB & FAMILY SERVICES
—
05
—
2496080
—
OH
01
—
271503047
MSBCBS
WV
01
—
271503047
TRICARE
—
05
—
3810000347
—
WV
01
—
614835100
FEDERAL WORKERS COMP
—
01
—
6608290
CIGNA
—
Enumeration date
06/17/2006
Last updated
05/26/2010
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