NPI 1760481014 · live from the CMS NPI Registry
Jonathan B Dale, MD
Emergency Medicine in Summersville, WV. National Provider Identifier 1760481014, active.
NPI record
| NPI | 1760481014 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Emergency Medicine 207P00000X |
| Practice location | 400 Fairview Heights Rd, Summersville, WV 26651 |
| Practice phone | 304-872-2891 |
| Mailing address | 200 Corporate Blvd, Lafayette, LA 70508 |
| Enumerated | July 19, 2005 |
| Last updated | April 21, 2022 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Family Medicine | 207Q00000X | 23453 (WV) |
| Emergency Medicine primary | 207P00000X | 23453 (WV) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.