Provider Demographics
NPI:1457422826
Name:IELAPI, MICHAEL ANTHONY II (DC)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:ANTHONY
Last Name:IELAPI
Suffix:II
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 T STEELE ST
Mailing Address - Street 2:
Mailing Address - City:BRIDGEPORT
Mailing Address - State:WV
Mailing Address - Zip Code:26330-1068
Mailing Address - Country:US
Mailing Address - Phone:304-842-7678
Mailing Address - Fax:304-842-5973
Practice Address - Street 1:101 T STEELE STREET
Practice Address - Street 2:
Practice Address - City:BRIDGEPORT
Practice Address - State:WV
Practice Address - Zip Code:26330
Practice Address - Country:US
Practice Address - Phone:304-842-7678
Practice Address - Fax:304-842-5973
Is Sole Proprietor?:No
Enumeration Date:2006-11-10
Last Update Date:2010-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVWV732111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WVWV732OtherHEALTH PLAN
WVU87550Medicare UPIN