Provider Demographics
NPI:1003866997
Name:SCHOR, JOEL ANTHONY (MD)
Entity Type:Individual
Prefix:DR
First Name:JOEL
Middle Name:ANTHONY
Last Name:SCHOR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1027 FREDERICK ST
Mailing Address - Street 2:
Mailing Address - City:BLUEFIELD
Mailing Address - State:WV
Mailing Address - Zip Code:24701-3942
Mailing Address - Country:US
Mailing Address - Phone:304-325-8104
Mailing Address - Fax:304-324-4267
Practice Address - Street 1:1027 FREDERICK ST
Practice Address - Street 2:
Practice Address - City:BLUEFIELD
Practice Address - State:WV
Practice Address - Zip Code:24701-3942
Practice Address - Country:US
Practice Address - Phone:304-325-8104
Practice Address - Fax:304-324-4267
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2015-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV15040174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV000194492OtherMT.STATE BC/BS
WVV002654OtherCHAMPUS
WV276040OtherFEDERAL BLACK LUNG
WV550659088003OtherPEIA (WV PUBLIC EMPL)
VA6063501Medicaid
WV0071093000Medicaid
WV830002821OtherMEDICARE/TRAVELERS
WV4653977OtherAETNA HEALTH PLANS
VA087343OtherTRIGON BC/BS OF VIRGINIA
WV830002821OtherMEDICARE/TRAVELERS
WVSC0599571Medicare ID - Type UnspecifiedPROVIDER ID