Provider Demographics
NPI:1659997641
Name:ISAACS, CANDACE ASHLEY (MD)
Entity Type:Individual
Prefix:MS
First Name:CANDACE
Middle Name:ASHLEY
Last Name:ISAACS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:58 16TH STREET
Mailing Address - Street 2:SUITE 200
Mailing Address - City:WHEELING
Mailing Address - State:WV
Mailing Address - Zip Code:26003-3660
Mailing Address - Country:US
Mailing Address - Phone:304-234-2111
Mailing Address - Fax:304-234-2006
Practice Address - Street 1:58 16TH STREET
Practice Address - Street 2:SUITE 200
Practice Address - City:WHEELING
Practice Address - State:WV
Practice Address - Zip Code:26003-3660
Practice Address - Country:US
Practice Address - Phone:304-234-2111
Practice Address - Fax:304-234-2006
Is Sole Proprietor?:No
Enumeration Date:2020-06-25
Last Update Date:2023-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
WV32534207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program