Provider Demographics
NPI:1700979812
Name:FINK, RODNEY L (DO)
Entity Type:Individual
Prefix:
First Name:RODNEY
Middle Name:L
Last Name:FINK
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2157 RITTER DR
Mailing Address - Street 2:
Mailing Address - City:DANIELS
Mailing Address - State:WV
Mailing Address - Zip Code:25832-9371
Mailing Address - Country:US
Mailing Address - Phone:304-763-4326
Mailing Address - Fax:304-763-4581
Practice Address - Street 1:2157 RITTER DR
Practice Address - Street 2:
Practice Address - City:DANIELS
Practice Address - State:WV
Practice Address - Zip Code:25832-9371
Practice Address - Country:US
Practice Address - Phone:304-763-4326
Practice Address - Fax:304-763-4581
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2007-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV1141207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0041591000Medicaid
WV18537Medicaid
205837OtherCARELINK
288987OtherUNITEDHEALTHCARE
WVA01141Medicaid
E75640OtherHEALTH NET
E75640OtherHEALTH NET
WVE75640Medicare ID - Type UnspecifiedUGS MEDICARE
WVFI2026305Medicare ID - Type Unspecified
WVA01141Medicaid