Provider Demographics
NPI:1285602284
Name:WEST, BRIAN (MD)
Entity type:Individual
Prefix:
First Name:BRIAN
Middle Name:
Last Name:WEST
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1062 MIDDLE DR
Mailing Address - Street 2:
Mailing Address - City:SAINT ALBANS
Mailing Address - State:WV
Mailing Address - Zip Code:25177-9585
Mailing Address - Country:US
Mailing Address - Phone:304-727-0504
Mailing Address - Fax:
Practice Address - Street 1:11605 E 23RD ST S
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:MO
Practice Address - Zip Code:64050-4201
Practice Address - Country:US
Practice Address - Phone:816-579-6891
Practice Address - Fax:816-579-6892
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-08
Last Update Date:2025-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101235713207Q00000X
WV23434207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010237726Medicaid
VAI29007Medicare UPIN
VA009448A25Medicare ID - Type Unspecified