Healthcare Provider Details

I. General information

NPI: 1154307791
Provider Name (Legal Business Name): DAVID A. AUGUST M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/15/2005
Last Update Date: 04/22/2024
Certification Date: 04/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 8255
MORGANTOWN WV
26506-8255
US

IV. Provider business mailing address

1 MEDICAL CENTER DRIVE PO BOX 8255
MORGANTOWN WV
26506
US

V. Phone/Fax

Practice location:
  • Phone: 304-598-4122
  • Fax:
Mailing address:
  • Phone: 304-598-4122
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberA876800
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207LP3000X
TaxonomyPediatric Anesthesiology Physician
License Number216143
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: