| Demetrio J Agcaoili Md Llc | |
|
51520 National Road E Suite 5 Saintclairsville OH 43950-8213 | |
| (740) 296-5931 | |
| (740) 296-5942 |
| Full Name | Demetrio J Agcaoili Md Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 51520 National Road E, Saintclairsville, Ohio |
| Authorized Official Name and Position | Demetrio Jose Agcaoili (OWNER) |
| Authorized Official Contact | 7406953703 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Demetrio J Agcaoili Md Llc 51520 National Road E Suite 5 Saintclairsville OH 43950-8213 Ph: (740) 296-5931 | Demetrio J Agcaoili Md Llc 51520 National Road E Suite 5 Saintclairsville OH 43950-8213 Ph: (740) 296-5931 |
| NPI Number | 1679643183 |
|---|---|
| Provider Enumeration Date | 11/09/2006 |
| Last Update Date | 07/23/2020 |
| Medicare PECOS PAC ID | 3577734318 |
|---|---|
| Medicare Enrollment ID | O20110927000611 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679643183 | NPI | - | NPPES |
| 1841957000 | Medicaid | WV | |
| 2413267 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RI0200X | Internal Medicine - Infectious Disease | 35083354 (Ohio) | Primary |
| Provider Name | Demetrio J Agcaoili |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1124040951 PECOS PAC ID: 0648167015 Enrollment ID: I20061218000209 |
| Provider Name | Gina Marie Cappiccie |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144818907 PECOS PAC ID: 0749698769 Enrollment ID: I20210412002215 |