David Montgomery McLellan, M.D.

Primary specialty

Neuromusculoskeletal Medicine & OMM PhysicianTaxonomy code 204D00000X

License

13066 Issued in WV

Practice address

1708 Locust Ave
Suite 102
Fairmont, WV 26554-1332

Phone

(304) 363-5799

Fax

(304) 366-0346

NPI assigned

Mar 27, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Marion Surgical Associates, Inc

  • Vascular Surgery Physician
  • Fairmont, WV
  • NPI 1073645826
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1235257973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1708 LOCUST AVE",
            "address_2": "SUITE 102",
            "city": "FAIRMONT",
            "state": "WV",
            "postal_code": "265541332",
            "telephone_number": "304-363-5799",
            "fax_number": "304-366-0346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1708 LOCUST AVE",
            "address_2": "SUITE 102",
            "city": "FAIRMONT",
            "state": "WV",
            "postal_code": "265541332",
            "telephone_number": "304-363-5799",
            "fax_number": "304-366-0346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCLELLAN",
        "first_name": "DAVID",
        "middle_name": "MONTGOMERY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204D00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine & OMM",
            "state": "WV",
            "license": "13066",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0128367000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Merica McIntire
• Tiffany McIntyre
• Brianna Nicole McKenzie
• Nancy E McKinley, MD
• Kristy Ann McKisic
• Hallie Ann McLeod, MA
• Ava McMullen
• Mark A McNeill
• Karalee McPherson, PHARMD
• Cheyann McQuain

• Neuromusculoskeletal Medicine & OMM Physician in Fairmont, WV
• Providers in Fairmont, WV by specialty
• Neuromusculoskeletal Medicine & OMM Physician in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.