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General NPI Number Information
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NPI Number | 1487729984
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Entity Type | Individual
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Provider Name | CHARLES EDWARD MCELFISH IV D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 11/21/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3979 TEAYS VALLEY RD
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City | HURRICANE
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State | WV
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Zip | 25526-9082
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Country | US
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Telephone | 304-757-7590
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Fax | 304-757-4108
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Provider Business Mailing Address
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Address Line | PO BOX 1127
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City | SCOTT DEPOT
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State | WV
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Zip | 25560-1127
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Country | US
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Telephone | 304-757-7590
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Fax | 304-757-4108
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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 | 2191
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License Number State | WV
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