Tg Medina Inc. | |
2 Chenoweth Dr Ste A Bridgeport WV 26330-1688 | |
(304) 842-5449 | |
(304) 842-5440 |
Full Name | Tg Medina Inc. |
---|---|
Speciality | Internal Medicine |
Location | 2 Chenoweth Dr Ste A, Bridgeport, West Virginia |
Authorized Official Name and Position | Teodoro G Medina (PRESIDENT) |
Authorized Official Contact | 3048425449 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Tg Medina Inc. 2 Chenoweth Dr Ste A Bridgeport WV 26330-1688 Ph: (304) 842-5449 | Tg Medina Inc. 2 Chenoweth Dr Ste A Bridgeport WV 26330-1688 Ph: (304) 842-5449 |
NPI Number | 1942343884 |
---|---|
Provider Enumeration Date | 02/14/2007 |
Last Update Date | 11/20/2007 |
Identifier | Type | State | Issuer |
---|---|---|---|
1942343884 | NPI | - | NPPES |
3810010371 | Medicaid | WV |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (* (Not Available)) | Primary |
207RG0100X | Internal Medicine - Gastroenterology | (* (Not Available)) | Secondary |
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