Individual
ANDREA M VALLEJOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1630 13TH AVENUE, HUNTINGTON, WV 25701
(304) 697-2014
Mailing address
P.O. BOX 1680, HUNTINGTON, WV 25717-1680
(304) 697-1396
(304) 697-2086
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
24052
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000306218
UNISON
WV
01
—
000000665311
ANTHEM
WV
05
—
3074284
—
OH
05
—
3810017819
—
WV
05
—
7100124710
—
KY
Enumeration date
05/09/2007
Last updated
12/22/2014
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