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General NPI Number Information
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NPI Number | 1093375404
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Entity Type | Individual
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Provider Name | MADELYN ROSE HARWELL DDS
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Gender | Female
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Dates
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Enumeration Date | 06/18/2019
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Last Update Date | 06/18/2019
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Provider Practice Location Address
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Address Line | 372 MIDDLEWAY PIKE STE A
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City | INWOOD
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State | WV
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Zip | 25428-3909
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Country | US
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Telephone | 304-229-5851
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Fax |
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Provider Business Mailing Address
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Address Line | 2500 WINCHESTER AVE
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City | MARTINSBURG
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State | WV
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Zip | 25405-5789
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Country | US
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Telephone | 304-549-5558
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 4408
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License Number State | WV
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