Provider Demographics
NPI:1821065467
Name:SHALEV, YOSEPH (MD)
Entity Type:Individual
Prefix:
First Name:YOSEPH
Middle Name:
Last Name:SHALEV
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 1:176 DAWKINS DR
Mailing Address - Street 2:
Mailing Address - City:LEWISBURG
Mailing Address - State:WV
Mailing Address - Zip Code:24901-9302
Mailing Address - Country:US
Mailing Address - Phone:304-793-2574
Mailing Address - Fax:414-219-7676
Practice Address - Street 1:176 DAWKINS DR
Practice Address - Street 2:
Practice Address - City:LEWISBURG
Practice Address - State:WV
Practice Address - Zip Code:24901-9302
Practice Address - Country:US
Practice Address - Phone:304-793-2574
Practice Address - Fax:414-219-7676
Is Sole Proprietor?:No
Enumeration Date:2006-03-02
Last Update Date:2022-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV3239207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI31936000Medicaid
002740245Medicare PIN
002754475Medicare PIN
WI31936000Medicaid
002704130Medicare PIN
F47273Medicare UPIN
002760350Medicare PIN