Individual
ALFONSO P CINCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
186 HOSPITAL DR, GRANTSVILLE, WV 26147-7100
(304) 354-9244
(304) 354-9323
Mailing address
186 HOSPITAL DR, GRANTSVILLE, WV 26147-7100
(304) 354-9244
(304) 354-9323
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
16604
WV
207R00000X
Internal Medicine Physician
16604
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0073879-000
—
WV
05
—
0073879000
—
WV
01
—
1679572051
BLUE SHIELD
WV
Enumeration date
07/19/2005
Last updated
07/12/2010
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