Organization
MINGO MEDICAL ASSOCIATES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. OSCAR P CARRILLO M.D. (PRESIDENT/PHYSICIAN)
(304) 475-3334
Entity
Organization
Contact information
Practice address
MAIN STREET, DELBARTON, WV 25670
(304) 475-3334
Mailing address
PO BOX 728, DELBARTON, WV 25670-0728
(304) 475-3334
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
12882
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0007488000
—
WV
Enumeration date
04/20/2006
Last updated
08/22/2020
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