Madelyn Rose Harwell, DDS
Individual provider
Active NPI
Dentist · Inwood, WV
NPI 1093375404 · NPPES record last updated Jun 18, 2019
Key facts
- NPI
- 1093375404
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 4408 (WV)
- Practice address
- 372 Middleway Pike Ste a
Inwood, WV 25428-3909
- Phone
- (304) 229-5851
- NPI assigned
- Jun 18, 2019
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WV
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|
| I20250605003452 |
WV |
Order and Referring Only - Dentist
Practitioner - Dentist |
5597275925 |
|
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|
| 4408 | WV | MD | Dentist |
Practice roles
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|
| Dentist |
122300000X |
4408 |
WV |
Yes |
Addresses
Primary practice location
372 Middleway Pike Ste a
Inwood, WV 25428-3909
Mailing address
2500 Winchester Ave
Martinsburg, WV 25405-5789
Phone (304) 549-5558
Other identifiers
| Identifier | Type | State | Issuer |
|---|
| 4408 | Medicaid | WV | |