Healthcare Provider Details

I. General information

NPI: 1669669453
Provider Name (Legal Business Name): KARYN LYNETTE MOLINARI-FRYER D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KARYN LYNETT FRYER DO

II. Dates (important events)

Enumeration Date: 09/26/2007
Last Update Date: 04/01/2020
Certification Date: 04/01/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

139 CONFERENCE CENTER WAY SUITE 113
BRIDGEPORT WV
26330
US

IV. Provider business mailing address

1247 SUNCREST TOWN CENTER
MORGANTOWN WV
26505
US

V. Phone/Fax

Practice location:
  • Phone: 304-599-8000
  • Fax: 304-599-8003
Mailing address:
  • Phone: 304-599-8000
  • Fax: 304-599-8003

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080A0000X
TaxonomyPediatric Adolescent Medicine Physician
License Number2090
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: