Provider Demographics
NPI:1932236700
Name:MECCA, RAYMOND VICTOR (MD)
Entity type:Individual
Prefix:DR
First Name:RAYMOND
Middle Name:VICTOR
Last Name:MECCA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1448 10TH AVE STE 304
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:25701-3579
Mailing Address - Country:US
Mailing Address - Phone:304-733-8728
Mailing Address - Fax:304-691-8591
Practice Address - Street 1:3246 US ROUTE 60 STE 6
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:WV
Practice Address - Zip Code:25705-2729
Practice Address - Country:US
Practice Address - Phone:304-691-8800
Practice Address - Fax:304-302-0221
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-27
Last Update Date:2024-01-16
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Provider Licenses
StateLicense IDTaxonomies
KY18044207W00000X
WV32988207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYC74209Medicare UPIN