Provider Demographics
NPI:1215218771
Name:CHESHIRE, MICHAEL DUANE (DO)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:DUANE
Last Name:CHESHIRE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2838 PIKE STREET
Mailing Address - Street 2:SUITE 1
Mailing Address - City:PARKERSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:26101
Mailing Address - Country:US
Mailing Address - Phone:304-865-5070
Mailing Address - Fax:304-489-4250
Practice Address - Street 1:2838 PIKE STREET
Practice Address - Street 2:SUITE 1
Practice Address - City:PARKERSBURG
Practice Address - State:WV
Practice Address - Zip Code:26101
Practice Address - Country:US
Practice Address - Phone:304-865-5070
Practice Address - Fax:304-489-4250
Is Sole Proprietor?:No
Enumeration Date:2011-08-29
Last Update Date:2022-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVED0106B207R00000X
WV2619207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine