Provider Demographics
NPI:1073699237
Name:AD GHAPHERY MD PROFESSIONAL ASSOCIATION
Entity Type:Organization
Organization Name:AD GHAPHERY MD PROFESSIONAL ASSOCIATION
Other - Org Name:DAVID A GHAPHERY MD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:A
Authorized Official - Last Name:GHAPHERY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:304-232-3520
Mailing Address - Street 1:601 NATIONAL ROAD
Mailing Address - Street 2:
Mailing Address - City:WHEELING
Mailing Address - State:WV
Mailing Address - Zip Code:26003
Mailing Address - Country:US
Mailing Address - Phone:304-232-3520
Mailing Address - Fax:304-232-8391
Practice Address - Street 1:601 NATIONAL ROAD
Practice Address - Street 2:
Practice Address - City:WHEELING
Practice Address - State:WV
Practice Address - Zip Code:26003
Practice Address - Country:US
Practice Address - Phone:304-232-3520
Practice Address - Fax:304-232-8391
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-31
Last Update Date:2008-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0125502000Medicaid
OH0978803Medicaid
OH9284572Medicare PIN
WVGH0743432Medicare ID - Type Unspecified
F62081Medicare UPIN
WV9284571Medicare PIN