Provider Demographics
NPI:1427158484
Name:SHIFFLER, JOEL DAVID (MD)
Entity type:Individual
Prefix:
First Name:JOEL
Middle Name:DAVID
Last Name:SHIFFLER
Suffix:
Gender:M
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:PO BOX 4370
Mailing Address - Street 2:
Mailing Address - City:PARKERSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:26104
Mailing Address - Country:US
Mailing Address - Phone:304-422-3999
Mailing Address - Fax:304-422-1454
Practice Address - Street 1:2003 MURDOCK
Practice Address - Street 2:STE A
Practice Address - City:PARKERSBURG
Practice Address - State:WV
Practice Address - Zip Code:26104
Practice Address - Country:US
Practice Address - Phone:304-422-3999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV20094WV207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV5630264001Medicaid
WV5630264001Medicaid
0898093Medicare ID - Type Unspecified