Provider Demographics
NPI:1083672307
Name:WEGLINSKI, LINDSAY MCDEVIT
Entity Type:Individual
Prefix:
First Name:LINDSAY
Middle Name:MCDEVIT
Last Name:WEGLINSKI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LINDSAY
Other - Middle Name:KRISTIN
Other - Last Name:MCDEVIT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 1127
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26507-1127
Mailing Address - Country:US
Mailing Address - Phone:304-598-4032
Mailing Address - Fax:304-598-4143
Practice Address - Street 1:608 CHEAT RD
Practice Address - Street 2:
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26508-4210
Practice Address - Country:US
Practice Address - Phone:304-594-1313
Practice Address - Fax:304-594-2408
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2008-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAML002771207P00000X
WV22331207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1015430020002Medicaid
WV3810009798Medicaid
I49242Medicare UPIN
PA1015430020002Medicaid
PA098134Medicare PIN