Provider Demographics
NPI:1316047020
Name:FERRERO, DAVID SR (DPM)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:
Last Name:FERRERO
Suffix:SR
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 FAIRMONT AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:FAIRMONT
Mailing Address - State:WV
Mailing Address - Zip Code:26554-5141
Mailing Address - Country:US
Mailing Address - Phone:304-367-1111
Mailing Address - Fax:304-367-1128
Practice Address - Street 1:900 FAIRMONT AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:FAIRMONT
Practice Address - State:WV
Practice Address - Zip Code:26554-5141
Practice Address - Country:US
Practice Address - Phone:304-367-1111
Practice Address - Fax:304-367-1128
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-23
Last Update Date:2014-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV248213ES0131X
PASC-003441-L213ES0131X
332B00000X, 335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0099603000Medicaid
WV0099603000Medicaid
WV0441630002Medicare NSC
WV0673583Medicare PIN