Lively, Mathew W

Lively, Mathew W is an individual health care provider with primary practice located at 2195 Cheat Rd Ste 2 , Morgantown WV 26508-4516. He recently has only one registered license in Allopathic & Osteopathic Physicians / Rheumatology, which is considered as his primary health care specialty. Lively, Mathew W can be contacted via phone (304) 594-0456.

Contact Information

Primary practice address
2195 Cheat Rd Ste 2 Morgantown WV 26508-4516
Phone: (304) 594-0456
Fax: (304) 594-3249
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Rheumatology 207RR0500X 1445 West Virginia

Profile Details

NPI number 1255444592
LBN Legal business name Lively, Mathew W
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 17th, 2006
Last updated Apr 2nd, 2018 - about 8 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 1255444592 NPPES
West Virginia MEDICAID 0048724000

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