Provider Demographics
NPI:1942276860
Name:COLEV, MICHELLE (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:
Last Name:COLEV
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:PO BOX 4355
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26504-4355
Mailing Address - Country:US
Mailing Address - Phone:304-685-9670
Mailing Address - Fax:
Practice Address - Street 1:200 ROUTE 98 W ST
Practice Address - Street 2:SUITE 304
Practice Address - City:NUTTER FORT
Practice Address - State:WV
Practice Address - Zip Code:26301-4385
Practice Address - Country:US
Practice Address - Phone:304-622-5880
Practice Address - Fax:304-622-5882
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-28
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV21845207W00000X
PAMD428960207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV3810001800Medicaid
PA104577Medicare PIN
I22834Medicare UPIN
WVCO4187041Medicare PIN