Provider Demographics
NPI:1609843960
Name:ALDIS, JOHN WARNER (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:WARNER
Last Name:ALDIS
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Gender:M
Credentials:MD
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Mailing Address - Street 1:4911 RIVER RD
Mailing Address - Street 2:
Mailing Address - City:SHEPHERDSTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:25443-5066
Mailing Address - Country:US
Mailing Address - Phone:304-876-6346
Mailing Address - Fax:301-619-2312
Practice Address - Street 1:171 TAYLOR ST
Practice Address - Street 2:
Practice Address - City:HARPERS FERRY
Practice Address - State:WV
Practice Address - Zip Code:25425-3641
Practice Address - Country:US
Practice Address - Phone:304-535-6343
Practice Address - Fax:304-535-6618
Is Sole Proprietor?:No
Enumeration Date:2006-03-07
Last Update Date:2022-07-21
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Provider Licenses
StateLicense IDTaxonomies
WV20707207QA0505X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV1609843960Medicaid