Provider Demographics
NPI:1285663047
Name:CZINEGE, ERVIN ILLES (MD)
Entity Type:Individual
Prefix:
First Name:ERVIN
Middle Name:ILLES
Last Name:CZINEGE
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 1:6026 WOODLAND BLUFF RD
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26508-9402
Mailing Address - Country:US
Mailing Address - Phone:304-599-7835
Mailing Address - Fax:
Practice Address - Street 1:6026 WOODLAND BLUFF RD
Practice Address - Street 2:
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26508
Practice Address - Country:US
Practice Address - Phone:304-599-7835
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-02
Last Update Date:2018-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV19733207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV5700253000Medicaid
WV001706469OtherMSBCBS GROUP
WVDA0096OtherRR MEDICARE
WV000758430OtherMSBCBS
WV486865600OtherDEPARTMENT OF LABOR
WV0207026000Medicaid
WV0207026000OtherMEDICAID GROUP
WV27005299701OtherWORKERS COMP
WV27005299700OtherWORKERS COMP
WV5700253000Medicaid
WVP00108399OtherRR MEDICARE
WV27005299701OtherBRICKSTREET
WV2122544OtherALLIANCE
WV000758430OtherMSBCBS
WV0207026000OtherMEDICAID GROUP
WVH05004Medicare UPIN