Provider Demographics
NPI:1457452252
Name:SHOWALTER, BARBARA MICHELLE (PT)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:MICHELLE
Last Name:SHOWALTER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:440 WATER ST
Mailing Address - Street 2:
Mailing Address - City:SUMMERSVILLE
Mailing Address - State:WV
Mailing Address - Zip Code:26651-1333
Mailing Address - Country:US
Mailing Address - Phone:304-872-3333
Mailing Address - Fax:304-872-2723
Practice Address - Street 1:440 WATER ST
Practice Address - Street 2:
Practice Address - City:SUMMERSVILLE
Practice Address - State:WV
Practice Address - Zip Code:26651-1333
Practice Address - Country:US
Practice Address - Phone:304-872-3333
Practice Address - Fax:304-872-2723
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2008-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV1275208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
409013775OtherRAILROAD MEDICARE
WV93991OtherUNICARE
WV001802372OtherBCBS
WV1025175OtherBRICKSTREET WORKERS COMP
WV0157465000Medicaid
409013775OtherRAILROAD MEDICARE