Provider Demographics
NPI:1720018922
Name:SOLARI, TED W (MD)
Entity Type:Individual
Prefix:DR
First Name:TED
Middle Name:W
Last Name:SOLARI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:230 GEORGE ST
Mailing Address - Street 2:SUITE 4
Mailing Address - City:BECKLEY
Mailing Address - State:WV
Mailing Address - Zip Code:25801-2620
Mailing Address - Country:US
Mailing Address - Phone:304-252-9227
Mailing Address - Fax:304-252-0454
Practice Address - Street 1:230 GEORGE ST
Practice Address - Street 2:SUITE 4
Practice Address - City:BECKLEY
Practice Address - State:WV
Practice Address - Zip Code:25801-2620
Practice Address - Country:US
Practice Address - Phone:304-252-9227
Practice Address - Fax:304-252-0454
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WV15471208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0106288000Medicaid
WVSO855502Medicare ID - Type Unspecified
WV0106288000Medicaid