Provider Demographics
NPI:1578607826
Name:ORTHOPAEDIC SURGERY INC.
Entity Type:Organization
Organization Name:ORTHOPAEDIC SURGERY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DEREK
Authorized Official - Middle Name:HUGH
Authorized Official - Last Name:ANDREINI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:304-242-6373
Mailing Address - Street 1:20 MEDICAL PARK STE 102
Mailing Address - Street 2:
Mailing Address - City:WHEELING
Mailing Address - State:WV
Mailing Address - Zip Code:26003-6390
Mailing Address - Country:US
Mailing Address - Phone:304-242-6373
Mailing Address - Fax:304-242-6371
Practice Address - Street 1:20 MEDICAL PARK STE 102
Practice Address - Street 2:
Practice Address - City:WHEELING
Practice Address - State:WV
Practice Address - Zip Code:26003-6390
Practice Address - Country:US
Practice Address - Phone:304-242-6373
Practice Address - Fax:304-242-6371
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-19
Last Update Date:2011-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV13314174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0099314000Medicaid
D49541Medicare UPIN
WV8804201Medicare ID - Type Unspecified