Provider Demographics
NPI:1639203508
Name:ARISTOTLE A RABANAL MD INC
Entity type:Organization
Organization Name:ARISTOTLE A RABANAL MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ARISTOTLE
Authorized Official - Middle Name:A
Authorized Official - Last Name:RABANAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:304-623-6517
Mailing Address - Street 1:PO BOX 409
Mailing Address - Street 2:
Mailing Address - City:CLARKSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:26302-0409
Mailing Address - Country:US
Mailing Address - Phone:304-623-6517
Mailing Address - Fax:304-624-1004
Practice Address - Street 1:OAKMOUND 409
Practice Address - Street 2:
Practice Address - City:CLARKSBURG
Practice Address - State:WV
Practice Address - Zip Code:26302-0409
Practice Address - Country:US
Practice Address - Phone:304-623-6517
Practice Address - Fax:304-624-1004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-15
Last Update Date:2007-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
No207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
D49531Medicare UPIN
RA8801622Medicare PIN