1083691893 NPI number — HANS GERHARD DRANSFELD MD

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1083691893 NPI number — HANS GERHARD DRANSFELD MD

Employer Identification Number (EIN):

Provider Organization Name:

Provider Last Name:

DRANSFELD

Provider First Name:

HANS

Provider Middle Name:

GERHARD

Provider Name Prefix Text:

Provider Name Suffix Text:

Provider Credential Text:

MD

Provider Gender Code:

M

Provider Other Organization Name:

Provider Other Organization Name Type Code:

Provider Other Last Name:

Provider Other First Name:

Provider Other Middle Name:

Provider Other Name Prefix Text:

Provider Other Name Suffix Text:

Provider Other Credential Text:

Provider Other Last Name Type Code:

NPI Number:

1083691893

Entity Type Code:

Individual

Replacement NPI:

Last Update Date:

01/08/2010

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider First Line Business Mailing Address:

PO BOX 910

Provider Second Line Business Mailing Address:

RADIOLOGY INC

Provider Business Mailing Address City Name:

HUNTINGTON

Provider Business Mailing Address State Name:

WV

Provider Business Mailing Address Postal Code:

25712-0910

Provider Business Mailing Address Country Code:

US

Provider Business Mailing Address Telephone Number:

304-522-1550

Provider Business Mailing Address Fax Number:

304-522-1073

Provider First Line Business Practice Location Address:

5221 US ROUTE 60 E

Provider Second Line Business Practice Location Address:

RADIOLOGY INC

Provider Business Practice Location Address City Name:

HUNTINGTON

Provider Business Practice Location Address State Name:

WV

Provider Business Practice Location Address Postal Code:

25705-2022

Provider Business Practice Location Address Country Code:

US

Provider Business Practice Location Address Telephone Number:

304-522-1550

Provider Business Practice Location Address Fax Number:

304-522-0704

Provider Enumeration Date:

12/22/2005

Authorized Official Last Name:

Authorized Official First Name:

Authorized Official Middle Name:

Authorized Official Title or Position:

Authorized Official Telephone Number:

• Taxonomy code: 2085R0202X , with the licence number:  16125 , registered in the state of WV ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
• Taxonomy code: 2085R0202X , with the licence number: 31524 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 2085R0202X , with the licence number: 35-080583-D , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

• Identifier: 001718773 . This is a "MTN STATE BC BS" identifier . This identifiers is of the category "OTHER".
• Identifier: 50007248 . This is a "PASSPORT" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
• Identifier: 300021805 . This is a "RR MEDICARE (WV)" identifier , issued by the state of ( WV ) . This identifiers is of the category "OTHER".
• Identifier: 550493376 00 . This is a "WORKMANS COMP" identifier , issued by the state of ( WV ) . This identifiers is of the category "OTHER".
• Identifier: 0797606 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
• Identifier: 4502391 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
• Identifier: 000000091296 . This is a "UNISON" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
• Identifier: 0118354000 , issued by the state of ( WV ) . This identifiers is of the category "MEDICAID".
• Identifier: 6469840000 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".