Corro, Prudencio C
Corro, Prudencio C is an sole proprietor health care provider with primary practice located at 673 Ritter Dr , Glen Morgan WV 25813-7707. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Otolaryngology, Allopathic & Osteopathic Physicians / Otolaryngic Allergy. Allopathic & Osteopathic Physicians / Otolaryngic Allergy is his primary health care specialty. Corro, Prudencio C can be contacted via phone (304) 252-0775.Contact Information
Primary practice address
673 Ritter Dr
Glen Morgan WV 25813-7707
Phone: (304) 252-0775
Fax: (304) 255-6688
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Otolaryngology | 207Y00000X | 5862 | West Virginia |
| Allopathic & Osteopathic Physicians / Otolaryngology | 207Y00000X | 9578 | West Virginia |
| Allopathic & Osteopathic Physicians / Otolaryngic Allergy | 207YX0602X | 9578 | West Virginia |
Profile Details
| NPI number | 1740238765 |
|---|---|
| LBN Legal business name | Corro, Prudencio C |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 4th, 2006 |
| Last updated | Dec 7th, 2020 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1740238765 | NPPES |
| West Virginia | MEDICAID | 0101068000 |
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