Healthcare Provider Details

I. General information

NPI: 1134144553
Provider Name (Legal Business Name): ERIKA ANNE PALLIE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2006
Last Update Date: 04/22/2024
Certification Date: 04/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2195 CHEAT RD
MORGANTOWN WV
26508-0022
US

IV. Provider business mailing address

2195 CHEAT RD
MORGANTOWN WV
26508-0022
US

V. Phone/Fax

Practice location:
  • Phone: 304-400-6145
  • Fax: 304-318-4584
Mailing address:
  • Phone: 304-400-6145
  • Fax: 304-284-0031

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number19248
License Number StateWV
# 2
Primary TaxonomyY
Taxonomy Code207QA0401X
TaxonomyAddiction Medicine (Family Medicine) Physician
License Number19248
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: