Healthcare Provider Details

I. General information

NPI: 1528971264
Provider Name (Legal Business Name): DAVID PAUL VANGILDER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/24/2026
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22 GARNET LN
WHITE HALL WV
26554-8437
US

IV. Provider business mailing address

22 GARNET LN
WHITE HALL WV
26554-8437
US

V. Phone/Fax

Practice location:
  • Phone: 681-404-9607
  • Fax:
Mailing address:
  • Phone: 681-404-9607
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: