Provider Demographics
NPI:1386743391
Name:ROMULO J ESTIGOY MD INC
Entity type:Organization
Organization Name:ROMULO J ESTIGOY MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROMULO
Authorized Official - Middle Name:J
Authorized Official - Last Name:ESTIGOY
Authorized Official - Suffix:
Authorized Official - Credentials:MEDICAL DOCTOR
Authorized Official - Phone:304-267-6726
Mailing Address - Street 1:121 N COLLEGE ST
Mailing Address - Street 2:
Mailing Address - City:MARTINSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:25401-3303
Mailing Address - Country:US
Mailing Address - Phone:304-267-6726
Mailing Address - Fax:304-264-8132
Practice Address - Street 1:121 N COLLEGE ST
Practice Address - Street 2:
Practice Address - City:MARTINSBURG
Practice Address - State:WV
Practice Address - Zip Code:25401-3303
Practice Address - Country:US
Practice Address - Phone:304-267-6726
Practice Address - Fax:304-264-8132
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV11918207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0083174000Medicaid
WV0083174000Medicaid
WV=========OtherALL OTHER INSURANCES
WV9201441Medicare ID - Type UnspecifiedMEDICARE ID NUMBER