Provider Demographics
NPI:1639715113
Name:SEEL, CHARLES EDWARD V
Entity type:Individual
Prefix:
First Name:CHARLES
Middle Name:EDWARD
Last Name:SEEL
Suffix:V
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:335 SCHOOL HOUSE RUN RD
Mailing Address - Street 2:
Mailing Address - City:ELKINS
Mailing Address - State:WV
Mailing Address - Zip Code:26241-5148
Mailing Address - Country:US
Mailing Address - Phone:304-940-5141
Mailing Address - Fax:
Practice Address - Street 1:80 SKYLINE PLAZA DR
Practice Address - Street 2:
Practice Address - City:BUCKHANNON
Practice Address - State:WV
Practice Address - Zip Code:26201-3902
Practice Address - Country:US
Practice Address - Phone:304-472-0715
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-20
Last Update Date:2019-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVRP0010934183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist