Provider Demographics
NPI:1376535096
Name:ANGER, ERIC R (MD)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:R
Last Name:ANGER
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 1:1 HEALTHCARE DR
Mailing Address - Street 2:
Mailing Address - City:PHILIPPI
Mailing Address - State:WV
Mailing Address - Zip Code:26416-9405
Mailing Address - Country:US
Mailing Address - Phone:304-457-1760
Mailing Address - Fax:304-457-1516
Practice Address - Street 1:1 HEALTHCARE DR
Practice Address - Street 2:
Practice Address - City:PHILIPPI
Practice Address - State:WV
Practice Address - Zip Code:26416-9405
Practice Address - Country:US
Practice Address - Phone:304-457-1760
Practice Address - Fax:304-457-1516
Is Sole Proprietor?:No
Enumeration Date:2005-08-18
Last Update Date:2022-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVBA8133655207Q00000X
WV20931207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WVP00381693OtherRAILROAD MEDICARE
WVWV20931AOtherHEALTH PLAN
WVP00679964OtherRAILROAD MEDICARE
WVWV20931BOtherHEALTH PLAN UNDER ANGER FAM. PRACTICE
WV20931OtherWV MEDICAL LICENSE NBR
WV1842171000Medicaid
WV001723077OtherMOUNTAIN STATE BCBS
WV20931OtherWV MEDICAL LICENSE NBR
WV001723077OtherMOUNTAIN STATE BCBS
WVH89278Medicare UPIN
WV4112055Medicare UPIN