Healthcare Provider Details

I. General information

NPI: 1619945755
Provider Name (Legal Business Name): DAVID S GEORGE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/14/2006
Last Update Date: 05/01/2024
Certification Date: 05/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

418 GRAND PARK DR SUITE 315
PARKERSBURG WV
26105-4000
US

IV. Provider business mailing address

418 GRAND PARK DR SUITE 315
PARKERSBURG WV
26105-4000
US

V. Phone/Fax

Practice location:
  • Phone: 304-428-3500
  • Fax: 304-422-7900
Mailing address:
  • Phone: 304-428-3500
  • Fax: 304-422-7900

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number35058948
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: