Provider Demographics
NPI:1417956053
Name:STARCHER, LARRY VICTOR II (MD)
Entity Type:Individual
Prefix:
First Name:LARRY
Middle Name:VICTOR
Last Name:STARCHER
Suffix:II
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 1:215 DON KNOTTS BLVD
Mailing Address - Street 2:SUITE 130
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26501-6734
Mailing Address - Country:US
Mailing Address - Phone:304-225-2500
Mailing Address - Fax:304-225-2576
Practice Address - Street 1:215 DON KNOTTS BLVD
Practice Address - Street 2:SUITE 130
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26501-6734
Practice Address - Country:US
Practice Address - Phone:304-291-3627
Practice Address - Fax:304-284-8667
Is Sole Proprietor?:No
Enumeration Date:2005-07-15
Last Update Date:2008-12-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WV20746207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV550783964007OtherMT STATE BCBS
WV1808301000Medicaid
WVWV20746AOtherHEALTH PLAN
WV550783964007OtherMT STATE BCBS
4081727Medicare ID - Type Unspecified