Healthcare Provider Details

I. General information

NPI: 1588685242
Provider Name (Legal Business Name): ORTHOPEDIC HEALTHCARE ASSOCIATES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/21/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

415 MORRIS ST STE 104
CHARLESTOWN WV
25301
US

IV. Provider business mailing address

415 MORRIS ST STE 104
CHARLESTOWN WV
25301
US

V. Phone/Fax

Practice location:
  • Phone: 304-343-1399
  • Fax: 304-345-7824
Mailing address:
  • Phone: 304-343-1399
  • Fax: 304-345-7824

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: TONY C MAJESTRO
Title or Position: PRESIDENT
Credential: MD
Phone: 304-343-4691