Provider Demographics
NPI:1932386034
Name:SAWEIKIS MEDICAL SERVICES, INC
Entity Type:Organization
Organization Name:SAWEIKIS MEDICAL SERVICES, INC
Other - Org Name:SAWEIKIS FAMILY MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:SAWEIKIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:304-788-0400
Mailing Address - Street 1:240 NEW CREEK HWY
Mailing Address - Street 2:
Mailing Address - City:KEYSER
Mailing Address - State:WV
Mailing Address - Zip Code:26726-0070
Mailing Address - Country:US
Mailing Address - Phone:304-788-0400
Mailing Address - Fax:304-788-2750
Practice Address - Street 1:240 NEW CREEK HWY
Practice Address - Street 2:
Practice Address - City:KEYSER
Practice Address - State:WV
Practice Address - Zip Code:26726-0070
Practice Address - Country:US
Practice Address - Phone:304-788-0400
Practice Address - Fax:304-788-2750
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-31
Last Update Date:2015-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV18383207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0054691000Medicaid