Healthcare Provider Details

I. General information

NPI: 1679826192
Provider Name (Legal Business Name): MICHAEL W. ESTES NP-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/22/2012
Last Update Date: 09/19/2022
Certification Date: 09/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 E COVE AVE
WHEELING WV
26003-5024
US

IV. Provider business mailing address

109 MOUNT WOOD RD
WHEELING WV
26003-2632
US

V. Phone/Fax

Practice location:
  • Phone: 304-242-4601
  • Fax: 304-242-3765
Mailing address:
  • Phone: 304-233-2455
  • Fax: 304-233-6073

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number71593
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: