| Appalachian Highway Medical & Surgical Clinic, Pllc | |
|
Appalachian Hwy, Rt. 10 East Pineville Pineville WV 24874-1274 | |
| (304) 732-9045 | |
| (304) 732-9055 |
| Full Name | Appalachian Highway Medical & Surgical Clinic, Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | Appalachian Hwy, Rt. 10 East Pineville, Pineville, West Virginia |
| Authorized Official Name and Position | Dominador Yti Lao (PHYSICIAN) |
| Authorized Official Contact | 3047329045 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Appalachian Highway Medical & Surgical Clinic, Pllc Appalachian Highway Rt. 10 East Pineville Pineville WV 24874-1274 Ph: (304) 732-9045 | Appalachian Highway Medical & Surgical Clinic, Pllc Appalachian Hwy, Rt. 10 East Pineville Pineville WV 24874-1274 Ph: (304) 732-9045 |
| NPI Number | 1255403002 |
|---|---|
| Provider Enumeration Date | 11/15/2006 |
| Last Update Date | 01/07/2019 |
| Medicare PECOS PAC ID | 9830199256 |
|---|---|
| Medicare Enrollment ID | O20070110000002 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255403002 | NPI | - | NPPES |
| 200001780 | Other | WV | RAILROAD MEDICARE |
| 00182204 | Other | WV | BLUE CROSS BLUE SHIELD |
| 0128304001 | Medicaid | WV | |
| 57799 | Other | WV | UNICARE |
| 1220372 | Other | WV | CHA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | 12700 (West Virginia) | Primary |
| Provider Name | Dominador Lao |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1366550279 PECOS PAC ID: 7012917438 Enrollment ID: I20070110000000 |
Pineville Children's Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: Us Route 10, Pineville, WV 24874 Phone: 304-732-7069 Fax: 304-732-7098 | |
Family Healthcare Associates Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 113 Main Ave, Pineville, WV 24874 Phone: 304-732-6611 Fax: 304-732-9161 | |
Pineville Childrens Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 585 Appalachian Highway, Pineville, WV 24874 Phone: 304-732-7069 Fax: 304-448-2101 |