Individual
JOSE JORGE GORDINHO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2962 ROBERT C. BYRD DRIVE, BECKLEY, WV 25801
(304) 254-9022
(304) 254-9024
Mailing address
2962 ROBERT C. BYRD DRIVE, BECKLEY, WV 25801
(304) 254-9022
(304) 254-9024
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
0101043986
VA
207RN0300X
Nephrology Physician
Primary
16005
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000553723
BLUE CROSS BLUE SHIELD
WV
05
—
005807000
—
VA
05
—
0072202000
—
WV
01
—
282397
BLUE CROSS BLUE SHIELD
VA
01
—
513901
MEDICARE PART A
PA
Enumeration date
03/30/2006
Last updated
07/10/2015
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