Healthcare Provider Details

I. General information

NPI: 1801050687
Provider Name (Legal Business Name): ANGER FAMILY PRACTICE, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/11/2008
Last Update Date: 04/27/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

62 BARNARD AVE
ELKINS WV
26241-3150
US

IV. Provider business mailing address

PO BOX 29 ANGER FAMILY PRACTICE, PLLC
ELKINS WV
26241-0029
US

V. Phone/Fax

Practice location:
  • Phone: 304-636-0133
  • Fax: 304-637-2007
Mailing address:
  • Phone: 304-637-3439
  • Fax: 304-637-3435

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number61887
License Number StateWV
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number20931
License Number StateWV

VIII. Authorized Official

Name: DR. ERIC RAY ANGER
Title or Position: MD/OWNER
Credential: M.D.
Phone: 304-636-0133