Provider Demographics
NPI:1932412442
Name:PICKERING, DAVID NEAL (DO)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:NEAL
Last Name:PICKERING
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1900 GARFIELD AVE STE A
Mailing Address - Street 2:
Mailing Address - City:PARKERSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:26101-2565
Mailing Address - Country:US
Mailing Address - Phone:877-377-8427
Mailing Address - Fax:304-699-0396
Practice Address - Street 1:1900 GARFIELD AVE STE A
Practice Address - Street 2:
Practice Address - City:PARKERSBURG
Practice Address - State:WV
Practice Address - Zip Code:26101-2565
Practice Address - Country:US
Practice Address - Phone:877-377-8427
Practice Address - Fax:304-699-0396
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-26
Last Update Date:2021-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV2485207R00000X, 207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0066900Medicaid
WV1932412442Medicaid
WVP01230581OtherRAILROAD MEDICARE - MHC PHYSICIANS
WVWV0094BMedicare PIN