Medina, Teodoro G
Medina, Teodoro G is an individual health care provider with primary practice located at 2 Chenoweth Dr Ste A , Bridgeport WV 26330-1688. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Gastroenterology, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Gastroenterology is his primary health care specialty. Medina, Teodoro G can be contacted via phone (304) 842-5449.Contact Information
Primary practice address
2 Chenoweth Dr Ste A
Bridgeport WV 26330-1688
Phone: (304) 842-5449
Fax: (304) 842-5440
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Gastroenterology | 207RG0100X | 12904 | West Virginia |
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 12904 | West Virginia |
Profile Details
| NPI number | 1134175094 |
|---|---|
| LBN Legal business name | Medina, Teodoro G |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 25th, 2006 |
| Last updated | Nov 7th, 2007 - about 19 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1134175094 | NPPES |
| West Virginia | MEDICAID | 0083622000 |
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