| Alfret Shakesprere | |
|
201 E 5th Ave Ranson WV 25438-1678 | |
| (304) 728-9797 | |
| Not Available |
| Full Name | Alfret Shakesprere |
|---|---|
| Speciality | Internal Medicine |
| Location | 201 E 5th Ave, Ranson, West Virginia |
| Authorized Official Name and Position | Alfret Norman Shakesprere (OWNER) |
| Authorized Official Contact | 3047289797 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Alfret Shakesprere 201 E 5th Ave Ranson WV 25438-1678 Ph: (304) 728-9797 | Alfret Shakesprere 201 E 5th Ave Ranson WV 25438-1678 Ph: (304) 728-9797 |
| NPI Number | 1588844435 |
|---|---|
| Provider Enumeration Date | 11/08/2007 |
| Last Update Date | 01/31/2008 |
| Medicare PECOS PAC ID | 1355363870 |
|---|---|
| Medicare Enrollment ID | O20051228000231 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588844435 | NPI | - | NPPES |
| 0080920000 | Medicaid | WV |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 19076 (West Virginia) | Primary |
| Provider Name | Alfret N Shakesprere |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1376509505 PECOS PAC ID: 4789606211 Enrollment ID: I20100317000060 |
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