Healthcare Provider Details

I. General information

NPI: 1457612608
Provider Name (Legal Business Name): RAYMOND A. HINERMAN MD PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/05/2012
Last Update Date: 06/05/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 MEDICAL PARK STE 223
WHEELING WV
26003-6391
US

IV. Provider business mailing address

109 MOUNT WOOD RD
WHEELING WV
26003-2632
US

V. Phone/Fax

Practice location:
  • Phone: 304-234-2060
  • Fax: 304-234-2070
Mailing address:
  • Phone: 304-233-2455
  • Fax: 304-233-6073

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number
License Number State

VIII. Authorized Official

Name: RAYMOND A HINERMAN JR.
Title or Position: OWNER
Credential:
Phone: 304-234-2060