MEDICARE: DR. NITESH RATNAKAR M.D.; FACG

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	22218	WV
2	207RG0100X	Gastroenterology Physician	35.096331	OH
3	207RG0300X	Geriatric Medicine (Internal Medicine) Physician	22218	WV
4	207RG0100X	Gastroenterology Physician	22218	WV

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
6	P00337365	OTHER	WV	RAILROAD MEDICARE
7	P00917561	OTHER	WV	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	WV22218	OTHER	WV	HEALTH PLAN
3	05723713	OTHER		ECFMG
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	001880418	OTHER	WV	MOUNTAIN STATE BCBS

General Provider Information

NPI Number	:	1285667410
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NITESH RATNAKAR M.D.; FACG

Provider Business Mailing Address
First Line	:	PO BOX 6230
Second Line	:
City	:	WHEELING
State	:	WV
Zip	:	26003-0722
Country	:	US
Telephone Number	:	304-242-7106
Fax Number	:	304-242-7108

Provider Business Practice Location Address
First Line	:	55 CHENOWETH CREEK RD
Second Line	:
City	:	ELKINS
State	:	WV
Zip	:	26241-9237
Country	:	US
Telephone Number	:	304-637-2360
Fax Number	:	304-637-2362

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/09/2006
Last Update Date	:	11/01/2021

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Directions to “ DR. NITESH RATNAKAR M.D.; FACG” Practice Location

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