Alasky, Desirae Shavon

Alasky, Desirae Shavon is an individual health care provider with primary practice located at 1664 E Pike St , Clarksburg WV 26301-6011. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Alasky, Desirae Shavon can be contacted via phone (304) 709-7000.

Contact Information

Primary practice address
1664 E Pike St Clarksburg WV 26301-6011
Fax: (304) 624-1780
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 2263 West Virginia

Profile Details

NPI number 1447436407
LBN Legal business name Alasky, Desirae Shavon
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 21st, 2008
Last updated Jan 29th, 2016 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1447436407 NPPES
West Virginia MEDICAID 3810018572

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