Michelle Gum

Individual provider Active NPI Community Health Worker · Salem, WV

NPI 1962087205 · NPPES record last updated Mar 17, 2021

Key facts

NPI
1962087205
Entity type
Individual (NPI type 1)
Primary specialty
Community Health Worker 172V00000X
Practice address
1178 New Creek Rd
Salem, WV 26426-8557
Phone
(304) 663-6206
NPI assigned
Mar 17, 2021
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Worker 172V00000X Yes

Addresses

Primary practice location

1178 New Creek Rd
Salem, WV 26426-8557

Mailing address

1178 New Creek Rd
Salem, WV 26426-8557
Phone (304) 663-6206

Other providers in Salem, WV

All providers in Salem, WV · Community Health Worker in West Virginia

Sources for this page

Verify at the official NPI Registry.