Provider Demographics
NPI:1780672519
Name:WHALIN, BRIAN G (MD)
Entity Type:Individual
Prefix:MR
First Name:BRIAN
Middle Name:G
Last Name:WHALIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3605 MURDOCH AVE
Mailing Address - Street 2:
Mailing Address - City:PARKERSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:26101-1026
Mailing Address - Country:US
Mailing Address - Phone:304-485-2700
Mailing Address - Fax:304-485-0481
Practice Address - Street 1:517 36TH ST
Practice Address - Street 2:
Practice Address - City:PARKERSBURG
Practice Address - State:WV
Practice Address - Zip Code:26101-1006
Practice Address - Country:US
Practice Address - Phone:304-485-1044
Practice Address - Fax:304-422-1861
Is Sole Proprietor?:No
Enumeration Date:2005-10-06
Last Update Date:2022-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV12097207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0540105Medicaid
WV0050237000Medicaid
WV0050237000Medicaid
OH0540105Medicaid
OH0578332Medicare PIN