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General NPI Number Information
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NPI Number | 1740284371
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Entity Type | Individual
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Provider Name | MICHAEL E. ANTON MD
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Gender | Male
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Dates
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Enumeration Date | 06/10/2005
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Last Update Date | 06/13/2024
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Provider Practice Location Address
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Address Line | 1120 KANAWHA BLVD E
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City | CHARLESTON
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State | WV
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Zip | 25301-2400
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Country | US
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Telephone | 304-344-3457
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Fax | 304-344-3480
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Provider Business Mailing Address
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Address Line | PO BOX 11137
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City | CHARLESTON
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State | WV
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Zip | 25339-1137
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Country | US
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Telephone | 304-344-3457
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Fax | 304-344-3480
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | MC-203
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License Number State | GU
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 21512
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License Number State | WV
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