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General NPI Number Information
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NPI Number | 1851371058
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Entity Type | Individual
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Provider Name | DAVID REVELL MD
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Gender | Male
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Dates
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Enumeration Date | 01/23/2006
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Last Update Date | 09/16/2013
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Provider Practice Location Address
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Address Line | 308 E MAIN ST
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City | MILTON
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State | WV
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Zip | 25541-1508
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Country | US
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Telephone | 304-743-4444
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1680
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City | HUNTINGTON
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State | WV
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Zip | 25717-1680
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Country | US
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Telephone |
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 10966
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License Number State | WV
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