Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204D00000X | Neuromusculoskeletal Medicine (NMM) | 1073 | WV |
Y | 207Q00000X | Family Doctor | 1073 | WV |
NPI | 1154424000 |
---|---|
Provider Name | David Hyler-Both |
First Address | Lewisburg, WV 24901-4049 |
Second Address | Rupert, WV 25984 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/09/2006 |
Last Update Date | 21/06/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
001371982 | BC/BS (01) | WV |
1014329 | BRICKSTREET (01) | WV |
288222 | ONE NET (01) | WV |
4458347 | AETNA (01) | WV |
888222 | OPTIMUM CHOICE (01) | WV |
E05967 | (02) | WV |