Provider Demographics
NPI:1861448904
Name:ALGINO, KENNETH MARTIN (MD)
Entity Type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:MARTIN
Last Name:ALGINO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1 RIVERSIDE CIR
Mailing Address - Street 2:SUITE 105
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24016-4961
Mailing Address - Country:US
Mailing Address - Phone:540-581-0150
Mailing Address - Fax:540-985-4537
Practice Address - Street 1:1 RIVERSIDE CIR
Practice Address - Street 2:SUITE 105
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24016-4961
Practice Address - Country:US
Practice Address - Phone:540-581-0150
Practice Address - Fax:540-985-4537
Is Sole Proprietor?:No
Enumeration Date:2006-05-26
Last Update Date:2016-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101241666207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00417626OtherRAILROAD MEDICARE
VA1861448904Medicaid
P00417626OtherRAILROAD MEDICARE
VA1861448904Medicaid