MEDICARE: LARRY VICTOR STARCHER II MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207P00000X	Emergency Medicine Physician	20746	WV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	550783964007	OTHER	WV	MT STATE BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	WV20746A	OTHER	WV	HEALTH PLAN

General Provider Information

NPI Number	:	1417956053
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LARRY VICTOR STARCHER II MD

Provider Business Mailing Address
First Line	:	215 DON KNOTTS BLVD
Second Line	:	SUITE 130
City	:	MORGANTOWN
State	:	WV
Zip	:	26501-6734
Country	:	US
Telephone Number	:	304-225-2500
Fax Number	:	304-225-2576

Provider Business Practice Location Address
First Line	:	215 DON KNOTTS BLVD
Second Line	:	SUITE 130
City	:	MORGANTOWN
State	:	WV
Zip	:	26501-6734
Country	:	US
Telephone Number	:	304-291-3627
Fax Number	:	304-284-8667

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/15/2005
Last Update Date	:	12/23/2008

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