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Contact Information

TAYLOR E DETCHEVERRY, PA-C
3100 MACCORKLE AVE SE STE 101
CHARLESTON, WV25304-1215
 Phone: 304-388-5395
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physician Assistant

363A00000X 97 Physician Assistant
 

Student in an Organized Health Care Education/Training Program

390200000X
 

Surgical Critical Care

2086S0102X 02 Physician/General Surgery
Indicates primary specialty

NPI Profile & details for TAYLOR E DETCHEVERRY · (Female)

NPI Number 1669943890
Status Active
Credentials PA-C (Physician Assistant-Certified)
Entity Individual
Enumeration date 12/16/2018
Last updated 08/08/2025 - About 10 months ago
Sole proprietor 1 No
Identifiers
  • VA License # 0110009282
  • WV License # 2268
Hospital affiliation(s)
  • WEST VIRGINIA UNIVERSITY HOSPITALS - (Acute Care)
    MEDICAL CENTER DRIVE
    MORGANTOWN, WV 26506
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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