Provider Demographics
NPI:1497730386
Name:RATLIFF, DAVID SUMMERS (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:SUMMERS
Last Name:RATLIFF
Suffix:
Gender:M
Credentials:MD
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Other - First Name:
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Mailing Address - Street 1:3665 TEAYS VALLEY RD
Mailing Address - Street 2:DAVID S RATLIFF INC
Mailing Address - City:HURRICANE
Mailing Address - State:WV
Mailing Address - Zip Code:25526-9701
Mailing Address - Country:US
Mailing Address - Phone:304-757-2518
Mailing Address - Fax:304-757-3271
Practice Address - Street 1:3665 TEAYS VALLEY RD
Practice Address - Street 2:DAVID S RATLIFF INC
Practice Address - City:HURRICANE
Practice Address - State:WV
Practice Address - Zip Code:25526-9701
Practice Address - Country:US
Practice Address - Phone:304-757-2518
Practice Address - Fax:304-757-3271
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-13
Last Update Date:2008-05-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WVWV15134208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0125164000Medicaid
2100717OtherMAMSI
WV000675240OtherWV BCBS
WV0125164000Medicaid
1497730386Medicare PIN