Mendoza, Ciriaco Ada

Mendoza, Ciriaco Ada is an individual health care provider with primary practice located at 122 12Th Street Ext , Princeton WV 24740-2352. He recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as his primary health care specialty. Mendoza, Ciriaco Ada can be contacted via phone (304) 487-7000.

Contact Information

Primary practice address
122 12Th Street Ext Princeton WV 24740-2352
Phone: (304) 487-7000
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 13884 West Virginia

Profile Details

NPI number 1376584508
LBN Legal business name Mendoza, Ciriaco Ada
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 9th, 2006
Last updated Nov 9th, 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1376584508 NPPES
West Virginia Other 000699368 BLUE CROSS
West Virginia MEDICAID 0052156-000 BLUE CROSS
West Virginia Other P00048451 BLUE CROSS
West Virginia Other 1044421 BLUE CROSS

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