PRUDENCIO C CORRO (NPI# 1740238765) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740238765 |
| Entity Type | Individual |
| Full Name | PRUDENCIO C CORRO |
| Credential | MD |
| Practice Address |
673 Ritter Dr Glen Morgan WV 25813-7707 |
| Practice Telephone | 3042520775 |
| Practice Fax Number | 3042556688 |
| Mailing Telephone | 3042520775 |
| Mailing Fax Number | 3042556688 |
| Enumeration Date | 2006-05-04 |
| Last Update Date | 2014-05-29 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Y00000X | Otolaryngology | 5862 | WV | Allopathic & Osteopathic Physicians |
| Y | 207YX0602X |
Otolaryngology Specialization: Otolaryngic Allergy |
5862 | WV | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WV | 0101068000 | 05 |
| Street Address |
673 RITTER DR |
| City | GLEN MORGAN |
| State | WV |
| Zip Code | 25813-7707 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174616262 | Raleigh Hearing Center, Inc. | Audiologist | 673 Ritter Dr, Glen Morgan, WV 25813-7707 | 2006-10-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992303689 | Jeanie Rae Hosler | Technician | 1897 Fitzpatrick Rd, Glen Morgan, WV 25813 | 2020-10-14 |
| 1699383448 | Anthony Ray Wills | Technician | 1110 Old Crow Rd, Beaver, WV 25813 | 2020-07-17 |
| 1053858191 | Mary Fox | Physical Therapy Assistant | 100 Grey Stone Drive, Beaver, WV 25813 | 2017-01-27 |
| 1912224676 | Amber Marie Lilly | Occupational Therapist | 200 Greystone Drive, Beaver, WV 25813 | 2010-04-21 |
| 1073735346 | Dominick Harry Mclain | Emergency Medicine | 1600 Industrial Park Road, Beaver, WV 25813 | 2007-05-03 |
| 1457476525 | M I Dababnah Md Inc | Clinic/Center | 856 S. Ritter Dr., Beaver, WV 25813 | 2007-03-20 |
| 1255477212 | Linkous Family Health Care LLC | Nurse Practitioner | 993 Ritter Drive, Beaver, WV 25813 | 2007-01-29 |
| 1033212493 | David Mccormack Dds | Dentist | 701 Ritter Dr, Beaver, WV 25813 | 2006-09-07 |
| 1518060276 | West Virginia Cvs Pharmacy LLC | Pharmacy | Rte 19 21 Ritter Drive, Beaver, WV 25813 | 2006-09-07 |
| 1518073907 | Sherry L Duvall | Nurse Practitioner | 134 Medical Place, Airport Industrial Park, Commerce Drive, Beaver, WV 25813 | 2006-08-21 |
| Find all providers in zip 25813 | ||||
| Taxonomy Code | 207YX0602X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| Specialization | Otolaryngic Allergy |
| An otolaryngologist who specializes in the diagnosis and treatment of otolaryngic allergies and other allergic diseases. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A Certification of Added Qualifications (CAQ) is issued by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457395808 | Charles Abraham | Otolaryngology | 1231 6th Ave, Huntington, WV 25701-2311 | 2006-06-16 |
| 1477899623 | Ear, Nose & Throat Physicians and Surgeons of Charleston, Pllc | Otolaryngology | 4408 Maccorkle Ave Se, Charleston, WV 25304-2506 | 2012-12-17 |
| 1780712752 | Joedy L Daristotle | Otolaryngology | 1712 Locust Ave, Fairmont, WV 26554-1321 | 2007-03-01 |
| City | GLEN MORGAN |
| Zip Code | 25813 |
Please comment or provide details below to improve the information on PRUDENCIO C CORRO.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.