MEDICARE: VINCENT EDWARD MONSEAU MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207P00000X	Emergency Medicine Physician	0101262068	VA
2	207P00000X	Emergency Medicine Physician	WV19052	WV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1780683847
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VINCENT EDWARD MONSEAU MD

Provider Business Mailing Address
First Line	:	3 E BENJAMIN DR
Second Line	:
City	:	NEW MARTINSVILLE
State	:	WV
Zip	:	26155-2705
Country	:	US
Telephone Number	:	304-455-8000
Fax Number	:	304-455-8154

Provider Business Practice Location Address
First Line	:	3 E BENJAMIN DR
Second Line	:
City	:	NEW MARTINSVILLE
State	:	WV
Zip	:	26155-2705
Country	:	US
Telephone Number	:	304-455-8000
Fax Number	:	304-455-8154

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/20/2005
Last Update Date	:	03/07/2023

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Directions to “ VINCENT EDWARD MONSEAU MD” Practice Location

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