Healthcare Provider Details

I. General information

NPI: 1578940649
Provider Name (Legal Business Name): DAVID MATTHEW PAXTON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/28/2015
Last Update Date: 09/19/2022
Certification Date: 09/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 EAST COVE AVE
WHEELING WV
26003
US

IV. Provider business mailing address

7 EAST COVE AVE
WHEELING WV
26003
US

V. Phone/Fax

Practice location:
  • Phone: 304-242-0770
  • Fax: 304-242-3647
Mailing address:
  • Phone: 304-242-0770
  • Fax: 304-242-3647

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number28180
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: