Provider Demographics
NPI:1801899513
Name:DAUWEL, GEORGE C (DC)
Entity type:Individual
Prefix:
First Name:GEORGE
Middle Name:C
Last Name:DAUWEL
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1616 N WALKER ST
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:WV
Mailing Address - Zip Code:24740-2653
Mailing Address - Country:US
Mailing Address - Phone:304-425-7695
Mailing Address - Fax:304-425-9864
Practice Address - Street 1:1616 N WALKER ST
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:WV
Practice Address - Zip Code:24740-2653
Practice Address - Country:US
Practice Address - Phone:304-425-7695
Practice Address - Fax:304-425-9864
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-05-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV172111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0132041000Medicaid
WVDAO388072Medicare ID - Type Unspecified
WV0132041000Medicaid