Healthcare Provider Details

I. General information

NPI: 1235233784
Provider Name (Legal Business Name): RAYMOND A HINERMAN DDS, M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/12/2006
Last Update Date: 04/06/2022
Certification Date: 04/06/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 MEDICAL PARK STE 223
WHEELING WV
26003-6391
US

IV. Provider business mailing address

800 WHEELING AVE
GLEN DALE WV
26038-1660
US

V. Phone/Fax

Practice location:
  • Phone: 304-234-2060
  • Fax: 304-234-2070
Mailing address:
  • Phone: 304-221-4541
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number21809
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: