Healthcare Provider Details

I. General information

NPI: 1497730386
Provider Name (Legal Business Name): DAVID SUMMERS RATLIFF MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/13/2005
Last Update Date: 05/07/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3665 TEAYS VALLEY RD DAVID S RATLIFF INC
HURRICANE WV
25526-9701
US

IV. Provider business mailing address

3665 TEAYS VALLEY RD DAVID S RATLIFF INC
HURRICANE WV
25526-9701
US

V. Phone/Fax

Practice location:
  • Phone: 304-757-2518
  • Fax: 304-757-3271
Mailing address:
  • Phone: 304-757-2518
  • Fax: 304-757-3271

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberWV15134
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: