Basic Information
| Provider Information | |||||||||
| NPI: | 1285667410 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | RATNAKAR | ||||||||
| FirstName: | NITESH | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D.; FACG | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 6230 | ||||||||
| Address2: | |||||||||
| City: | WHEELING | ||||||||
| State: | WV | ||||||||
| PostalCode: | 260030722 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3042427106 | ||||||||
| FaxNumber: | 3042427108 | ||||||||
| Practice Location | |||||||||
| Address1: | 55 CHENOWETH CREEK RD | ||||||||
| Address2: | |||||||||
| City: | ELKINS | ||||||||
| State: | WV | ||||||||
| PostalCode: | 262419237 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3046372360 | ||||||||
| FaxNumber: | 3046372362 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/09/2006 | ||||||||
| LastUpdateDate: | 11/01/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 11/01/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 22218 | WV | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RG0100X | 35.096331 | OH | N | Allopathic & Osteopathic Physicians | Internal Medicine | Gastroenterology | 207RG0300X | 22218 | WV | N | Allopathic & Osteopathic Physicians | Internal Medicine | Geriatric Medicine | 207RG0100X | 22218 | WV | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Gastroenterology |
ID Information
| ID | Type | State | Issuer | Description | 3130356 | 05 | OH | MEDICAID | WV22218 | 01 | WV | HEALTH PLAN | OTHER | 05723713 | 01 | ECFMG | OTHER | 3810005835 | 05 | WV | MEDICAID | 001880418 | 01 | WV | MOUNTAIN STATE BCBS | OTHER | P00337365 | 01 | WV | RAILROAD MEDICARE | OTHER | P00917561 | 01 | WV | RAILROAD MEDICARE | OTHER |