Provider Demographics
NPI:1043318843
Name:ESHEL, AMIR ISRAEL (MD)
Entity Type:Individual
Prefix:DR
First Name:AMIR
Middle Name:ISRAEL
Last Name:ESHEL
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 1:12302 VETERANS MEMORIAL HWY
Mailing Address - Street 2:
Mailing Address - City:REEDSVILLE
Mailing Address - State:WV
Mailing Address - Zip Code:26547
Mailing Address - Country:US
Mailing Address - Phone:304-864-0552
Mailing Address - Fax:304-864-2827
Practice Address - Street 1:12302 VETERANS MEMORIAL HWY
Practice Address - Street 2:
Practice Address - City:REEDSVILLE
Practice Address - State:WV
Practice Address - Zip Code:26547
Practice Address - Country:US
Practice Address - Phone:304-864-0552
Practice Address - Fax:304-864-2827
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2017-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV17178207V00000X
FLME59928207V00000X
KYTP156207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV009245500Medicaid
FL279672400Medicaid
WV009245500Medicaid
FLAG013YMedicare PIN
WV4275091Medicare PIN
F09574Medicare UPIN
FLAG013XMedicare PIN
FL279672400Medicaid