Provider Demographics
NPI:1841296654
Name:AGUIRRE, ALFREDO A (MD)
Entity type:Individual
Prefix:DR
First Name:ALFREDO
Middle Name:A
Last Name:AGUIRRE
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 1:32 20TH ST STE 500
Mailing Address - Street 2:
Mailing Address - City:WHEELING
Mailing Address - State:WV
Mailing Address - Zip Code:26003-3747
Mailing Address - Country:US
Mailing Address - Phone:304-218-2023
Mailing Address - Fax:
Practice Address - Street 1:32 20TH ST STE 500
Practice Address - Street 2:
Practice Address - City:WHEELING
Practice Address - State:WV
Practice Address - Zip Code:26003-3747
Practice Address - Country:US
Practice Address - Phone:304-218-2023
Practice Address - Fax:304-218-2026
Is Sole Proprietor?:No
Enumeration Date:2005-06-27
Last Update Date:2021-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV169182084P0800X
PAMD045486E2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0115328000Medicaid
E28351Medicare UPIN
WV0115328000Medicaid