Provider Demographics
NPI:1235244898
Name:ANDREINI, DEREK HUGH (MD)
Entity Type:Individual
Prefix:
First Name:DEREK
Middle Name:HUGH
Last Name:ANDREINI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 MEDICAL PARK
Mailing Address - Street 2:SUITE 703
Mailing Address - City:WHEELING
Mailing Address - State:WV
Mailing Address - Zip Code:26003
Mailing Address - Country:US
Mailing Address - Phone:304-242-6373
Mailing Address - Fax:304-242-6371
Practice Address - Street 1:1 MEDICAL PARK
Practice Address - Street 2:SUITE 703
Practice Address - City:WHEELING
Practice Address - State:WV
Practice Address - Zip Code:26003
Practice Address - Country:US
Practice Address - Phone:304-242-6373
Practice Address - Fax:304-242-6371
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2020-06-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WV13314207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV3136298Medicaid
OH0624328Medicaid
WV0099314000Medicaid
WV0099314000Medicaid