Provider Demographics
NPI:1972697969
Name:IGNATIADIS, PANAYOTIS (MD)
Entity Type:Individual
Prefix:DR
First Name:PANAYOTIS
Middle Name:
Last Name:IGNATIADIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 4190
Mailing Address - Street 2:
Mailing Address - City:BARBOURSVILLE
Mailing Address - State:WV
Mailing Address - Zip Code:25504-4190
Mailing Address - Country:US
Mailing Address - Phone:304-399-4405
Mailing Address - Fax:304-399-2526
Practice Address - Street 1:2900 1ST AVE
Practice Address - Street 2:OPC SUITE 10
Practice Address - City:HUNTINGTON
Practice Address - State:WV
Practice Address - Zip Code:25702-0107
Practice Address - Country:US
Practice Address - Phone:304-525-6825
Practice Address - Fax:304-525-0300
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2022-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV12268207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000287965OtherOH UNISON
WV0089539000Medicaid
OH0442819Medicaid
WV0790289OtherCIGNA
WV613918805OtherBLACK LUNG/FECA
KY64694177Medicaid
OH000000287965OtherOH UNISON
WV0790289OtherCIGNA
KY64694177Medicaid