Provider Demographics
NPI:1053364778
Name:CIPOLETTI, PATSY P (MD)
Entity type:Individual
Prefix:DR
First Name:PATSY
Middle Name:P
Last Name:CIPOLETTI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1421 COMMERCE STREET
Mailing Address - Street 2:
Mailing Address - City:WELLSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:26070-1320
Mailing Address - Country:US
Mailing Address - Phone:304-737-3425
Mailing Address - Fax:304-737-2610
Practice Address - Street 1:1421 COMMERCE STREET
Practice Address - Street 2:
Practice Address - City:WELLSBURG
Practice Address - State:WV
Practice Address - Zip Code:26070-1320
Practice Address - Country:US
Practice Address - Phone:304-737-3425
Practice Address - Fax:304-737-2610
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WV11987207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0049808000Medicaid
B42581Medicare UPIN
C10481592Medicare ID - Type Unspecified