Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0300X | Periodontist | 2993 | WV |
NPI | 1154332070 |
---|---|
Provider Name | Dr. Richard Craig Newhart |
First Address | Parkersburg, WV 26101 |
Second Address | Parkersburg, WV 26101 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/08/2006 |
Last Update Date | 08/07/2007 |