Provider Demographics
NPI:1598730327
Name:KERR, RICHARD S (MD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:S
Last Name:KERR
Suffix:
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 1:200 WEDGEWOOD DR
Mailing Address - Street 2:SUITE #201
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26505-2442
Mailing Address - Country:US
Mailing Address - Phone:304-599-6353
Mailing Address - Fax:304-598-3608
Practice Address - Street 1:200 WEDGEWOOD DR
Practice Address - Street 2:SUITE #201
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26505-2442
Practice Address - Country:US
Practice Address - Phone:304-599-6353
Practice Address - Fax:304-598-3608
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-23
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV09017207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV229254OtherUNITED HEALTHCARE/MAMSI
WVWV09017OtherHEALTH PLAN
WVV002549OtherTRICARE
WV1504258-002OtherCIGNA
WV0094809000Medicaid
WVKE0818081Medicare ID - Type UnspecifiedINDIVIDUAL NUMBER
WVA71832Medicare UPIN
WVV002549OtherTRICARE