Healthcare Provider Details

I. General information

NPI: 1346014628
Provider Name (Legal Business Name): CHRISITIAN FEIL
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/08/2023
Last Update Date: 11/08/2023
Certification Date: 11/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

208 UNIVERSITY DR
WEST LIBERTY WV
26074-1082
US

IV. Provider business mailing address

59 BEAR CREEK DR
MORGANTOWN WV
26508-4549
US

V. Phone/Fax

Practice location:
  • Phone: 304-336-5000
  • Fax:
Mailing address:
  • Phone: 801-556-0266
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: