Provider Demographics
NPI:1710186580
Name:VICTOR T PERRONE, MD
Entity Type:Organization
Organization Name:VICTOR T PERRONE, MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VICTOR
Authorized Official - Middle Name:T
Authorized Official - Last Name:PERRONE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:304-233-2455
Mailing Address - Street 1:PO BOX 6349
Mailing Address - Street 2:
Mailing Address - City:WHEELING
Mailing Address - State:WV
Mailing Address - Zip Code:26003-0800
Mailing Address - Country:US
Mailing Address - Phone:304-233-2455
Mailing Address - Fax:304-233-6073
Practice Address - Street 1:40 MEDICAL PARK
Practice Address - Street 2:SUITE 505
Practice Address - City:WHEELING
Practice Address - State:WV
Practice Address - Zip Code:26003-6392
Practice Address - Country:US
Practice Address - Phone:304-232-4764
Practice Address - Fax:304-232-0404
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-12
Last Update Date:2007-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0747802Medicaid
WV0072105000Medicaid
OH0747802Medicaid
WV0072105000Medicaid