Provider Demographics
NPI:1538231063
Name:ZALESKI, ROBERT J (MD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:J
Last Name:ZALESKI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 MEDICAL PARK STE 203
Mailing Address - Street 2:
Mailing Address - City:WHEELING
Mailing Address - State:WV
Mailing Address - Zip Code:26003-6389
Mailing Address - Country:US
Mailing Address - Phone:304-242-9460
Mailing Address - Fax:304-242-6958
Practice Address - Street 1:10 MEDICAL PARK STE 203
Practice Address - Street 2:
Practice Address - City:WHEELING
Practice Address - State:WV
Practice Address - Zip Code:26003-6389
Practice Address - Country:US
Practice Address - Phone:304-242-9460
Practice Address - Fax:304-242-6958
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-13
Last Update Date:2013-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV12456207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0099195000Medicaid
OH0437656Medicaid
OH0437656Medicaid
WV0099195000Medicaid