Provider Demographics
NPI:1285667410
Name:RATNAKAR, NITESH (MD; FACG)
Entity Type:Individual
Prefix:DR
First Name:NITESH
Middle Name:
Last Name:RATNAKAR
Suffix:
Gender:M
Credentials:MD; FACG
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6230
Mailing Address - Street 2:
Mailing Address - City:WHEELING
Mailing Address - State:WV
Mailing Address - Zip Code:26003-0722
Mailing Address - Country:US
Mailing Address - Phone:304-242-7106
Mailing Address - Fax:304-242-7108
Practice Address - Street 1:55 CHENOWETH CREEK RD
Practice Address - Street 2:
Practice Address - City:ELKINS
Practice Address - State:WV
Practice Address - Zip Code:26241-9237
Practice Address - Country:US
Practice Address - Phone:304-637-2360
Practice Address - Fax:304-637-2362
Is Sole Proprietor?:No
Enumeration Date:2006-07-09
Last Update Date:2021-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV22218207R00000X, 207RG0300X, 207RG0100X
OH35.096331207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3130356Medicaid
WVWV22218OtherHEALTH PLAN
05723713OtherECFMG
WV3810005835Medicaid
WV001880418OtherMOUNTAIN STATE BCBS
WVP00337365OtherRAILROAD MEDICARE
WVP00917561OtherRAILROAD MEDICARE
OHH019461Medicare PIN
WVP00337365OtherRAILROAD MEDICARE
WVP00917561OtherRAILROAD MEDICARE
OH3130356Medicaid
WV3810005835Medicaid