Provider Demographics
NPI:1073654075
Name:WESTMORELAND, DANNY RAY (DO)
Entity type:Individual
Prefix:DR
First Name:DANNY
Middle Name:RAY
Last Name:WESTMORELAND
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 2ND ST
Mailing Address - Street 2:
Mailing Address - City:MASON
Mailing Address - State:WV
Mailing Address - Zip Code:25260-9677
Mailing Address - Country:US
Mailing Address - Phone:304-773-5333
Mailing Address - Fax:304-773-5885
Practice Address - Street 1:16 2ND ST
Practice Address - Street 2:
Practice Address - City:MASON
Practice Address - State:WV
Practice Address - Zip Code:25260-9677
Practice Address - Country:US
Practice Address - Phone:304-773-5333
Practice Address - Fax:304-773-5885
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-11
Last Update Date:2014-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV1070207Q00000X
OH34-00-4177207Q00000X
FLOS-0006018207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000185376Medicaid
OH0639572Medicaid
WV0040703000Medicaid
OH0639572Medicaid