{
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"EIN": null,
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"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "ROMULO J ESTIGOY MD INC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "121 N COLLEGE ST",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "MARTINSBURG",
"MailingAddressStateName": "WV",
"MailingAddressPostalCode": "25401-3303",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "304-267-6726",
"MailingAddressFaxNumber": "304-264-8132",
"FirstLinePracticeLocationAddress": "121 N COLLEGE ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "MARTINSBURG",
"PracticeLocationAddressStateName": "WV",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "304-267-6726",
"PracticeLocationAddressFaxNumber": "304-264-8132",
"EnumerationDate": "09/22/2006",
"LastUpdateDate": "08/22/2020",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "ESTIGOY",
"AuthorizedOfficialFirstName": "ROMULO",
"AuthorizedOfficialMiddleName": "J",
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "MEDICAL DOCTOR",
"AuthorizedOfficialTelephoneNumber": "304-267-6726",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "207R00000X",
"TaxonomyName": "Internal Medicine Physician",
"LicenseNumber": "11918",
"LicenseNumberStateCode": "WV",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}