Provider Demographics
NPI:1235245341
Name:ROIG, JORGE W (MD)
Entity Type:Individual
Prefix:
First Name:JORGE
Middle Name:W
Last Name:ROIG
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 1:109 MOUNT WOOD RD
Mailing Address - Street 2:
Mailing Address - City:WHEELING
Mailing Address - State:WV
Mailing Address - Zip Code:26003-2632
Mailing Address - Country:US
Mailing Address - Phone:304-233-2455
Mailing Address - Fax:
Practice Address - Street 1:651 COLLIERS WAY STE 510
Practice Address - Street 2:
Practice Address - City:WEIRTON
Practice Address - State:WV
Practice Address - Zip Code:26062-5054
Practice Address - Country:US
Practice Address - Phone:304-797-6595
Practice Address - Fax:304-797-6052
Is Sole Proprietor?:No
Enumeration Date:2006-08-22
Last Update Date:2022-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-079250207L00000X
WV20028207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV050079781OtherRR MEDICARE
OH2249945Medicaid
WV1804712000Medicaid
OH050080517OtherRR MEDICARE
WV4044512Medicare PIN
OHRO4044514Medicare PIN
WV4044515Medicare PIN
OH050080517OtherRR MEDICARE
WVRO4044511Medicare PIN