Provider Demographics
NPI:1780685727
Name:MASSEY, LEIGH ANNE (MD)
Entity Type:Individual
Prefix:
First Name:LEIGH ANNE
Middle Name:
Last Name:MASSEY
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 1:2108 LUMBER AVE STE 2
Mailing Address - Street 2:
Mailing Address - City:WHEELING
Mailing Address - State:WV
Mailing Address - Zip Code:26003-5350
Mailing Address - Country:US
Mailing Address - Phone:304-234-8030
Mailing Address - Fax:304-234-8032
Practice Address - Street 1:2108 LUMBER AVE STE 2
Practice Address - Street 2:
Practice Address - City:WHEELING
Practice Address - State:WV
Practice Address - Zip Code:26003-5350
Practice Address - Country:US
Practice Address - Phone:304-234-8030
Practice Address - Fax:304-234-8032
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-01
Last Update Date:2019-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35076094P207VG0400X
WV17665207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0093249000Medicaid
WVPA0862432Medicare ID - Type Unspecified
WV0093249000Medicaid