NPI 1770979874 · live from the CMS NPI Registry
Michael Vaughn Baxter Bledsoe, D.O.
Family Medicine in Ronceverte, WV. National Provider Identifier 1770979874, active.
NPI record
| NPI | 1770979874 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Family Medicine 207Q00000X |
| Practice location | 1320 Maplewood Ave, Ronceverte, WV 24970 |
| Practice phone | 304-647-4411 |
| Enumerated | April 15, 2015 |
| Last updated | October 23, 2026 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Family Medicine primary | 207Q00000X | 3097 (WV) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.