Provider Demographics
NPI:1801924832
Name:SPINDEL, MICHAEL ROY (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:ROY
Last Name:SPINDEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2860 3RD AVE
Mailing Address - Street 2:SUITE 220
Mailing Address - City:HUNTINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:25702-1454
Mailing Address - Country:US
Mailing Address - Phone:304-697-5272
Mailing Address - Fax:
Practice Address - Street 1:2860 3RD AVE
Practice Address - Street 2:SUITE 220
Practice Address - City:HUNTINGTON
Practice Address - State:WV
Practice Address - Zip Code:25702-1454
Practice Address - Country:US
Practice Address - Phone:304-697-5272
Practice Address - Fax:304-697-5273
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-01
Last Update Date:2010-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV173178208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0927635Medicaid
WV001721536OtherBLUE CROSS BLUE SHIELD
WV0130262000Medicaid
WV550726401-00OtherWORKERS COMPENSATION
WV0743051Medicare ID - Type Unspecified
OH0927635Medicaid