APPALACHIAN HIGHWAY MEDICAL & SURGICAL CLINIC PLLC NPI 1255403002

NPI Information

NPI: 1255403002
Provider Name: APPALACHIAN HIGHWAY MEDICAL & SURGICAL CLINIC, PLLC
Classification: Clinic/Center - 261QM1300X
Specialization: Multi-Specialty
Entity Type: Organization
Address: APPALACHIAN HWY, RT. 10 EAST PINEVILLE
PINEVILLE, WV
ZIP 24874
Phone: (304) 732-9045

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NPI Details

APPALACHIAN HIGHWAY MEDICAL & SURGICAL CLINIC, PLLC is a multi-specialty clinic center in Pineville, WV. APPALACHIAN HIGHWAY MEDICAL & SURGICAL CLINIC, PLLC NPI is 1255403002. The provider is registered as an organization entity type.

The provider's business location address is:

APPALACHIAN HWY, RT. 10 EAST PINEVILLE
PINEVILLE, WV
ZIP 24874-274
Phone: (304) 732-9045
Fax: (304) 732-9055

The provider's authorized official is Dominador Yti Lao .
The authorized official title is Physician and has the following contact phone number (304) 732-9045.

The enumeration date for this NPI number is 11/15/2006 and was last updated on 1/7/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QM1300X	Clinic/Center	Multi-Specialty	12700	WEST VIRGINIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	00182204	OTHER	WEST VIRGINIA	BLUE CROSS BLUE SHIELD
2	200001780	OTHER	WEST VIRGINIA	RAILROAD MEDICARE
3	57799	OTHER	WEST VIRGINIA	UNICARE
4	0128304001	MEDICAID	WEST VIRGINIA
5	1220372	OTHER	WEST VIRGINIA	CHA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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