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NPI Code Detail

MEDICARE: ROBERTO CHRISTIAN VALENZUELA MD

MEDICARE: ROBERTO CHRISTIAN VALENZUELA MD
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
1207LP2900XPain Medicine (Anesthesiology) Physician15563WV
2207L00000XAnesthesiology Physician22635SC
3207L00000XAnesthesiology PhysicianMD465074PA
4207L00000XAnesthesiology Physician15563WV
5207L00000XAnesthesiology Physician35.079981OH

General Provider Information

NPI Number : 1104858521
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROBERTO CHRISTIAN VALENZUELA MD
Provider Business Mailing Address
First Line : PO BOX 3466
Second Line :
City : CHARLESTON
State : WV
Zip : 25334-3466
Country : US
Telephone Number : 304-720-8816
Fax Number : 904-494-6467
Provider Business Practice Location Address
First Line : 2000 MON HEALTH MEDICAL PARK DR STE 2001
Second Line :
City : MORGANTOWN
State : WV
Zip : 26505-1167
Country : US
Telephone Number : 304-720-8816
Fax Number : 904-494-6467
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/07/2006
Last Update Date : 12/16/2025

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