Healthcare Provider Details

I. General information

NPI: 1558660480
Provider Name (Legal Business Name): BRIAN PATRICK PEPPERS PH.D., D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/17/2011
Last Update Date: 10/30/2025
Certification Date: 10/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

608 CHEAT RD
MORGANTOWN WV
26508-4210
US

IV. Provider business mailing address

608 CHEAT RD
MORGANTOWN WV
26508-4210
US

V. Phone/Fax

Practice location:
  • Phone: 304-594-1313
  • Fax: 304-594-2408
Mailing address:
  • Phone: 304-594-1313
  • Fax: 304-594-2408

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number3250
License Number StateWV
# 2
Primary TaxonomyN
Taxonomy Code2080P0201X
TaxonomyPediatric Allergy/Immunology Physician
License Number3250
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: