Provider Demographics
NPI:1205817053
Name:CELLINI, ALDINO G (MD)
Entity Type:Individual
Prefix:DR
First Name:ALDINO
Middle Name:G
Last Name:CELLINI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1717 HARPER RD FL 2
Mailing Address - Street 2:
Mailing Address - City:BECKLEY
Mailing Address - State:WV
Mailing Address - Zip Code:25801-3373
Mailing Address - Country:US
Mailing Address - Phone:304-461-3909
Mailing Address - Fax:304-461-3916
Practice Address - Street 1:1717 HARPER RD FL 2
Practice Address - Street 2:
Practice Address - City:BECKLEY
Practice Address - State:WV
Practice Address - Zip Code:25801-3373
Practice Address - Country:US
Practice Address - Phone:304-461-3909
Practice Address - Fax:304-461-3916
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-09
Last Update Date:2022-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV20765207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL269434400Medicaid
WV1205817053Medicaid
FL269434400Medicaid