Provider Demographics
NPI:1669669453
Name:MOLINARI-FRYER, KARYN LYNETTE (DO)
Entity Type:Individual
Prefix:MRS
First Name:KARYN
Middle Name:LYNETTE
Last Name:MOLINARI-FRYER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:KARYN
Other - Middle Name:LYNETT
Other - Last Name:FRYER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DO
Mailing Address - Street 1:1247 SUNCREST TOWN CENTER
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26505
Mailing Address - Country:US
Mailing Address - Phone:304-599-8000
Mailing Address - Fax:304-599-8003
Practice Address - Street 1:139 CONFERENCE CENTER WAY
Practice Address - Street 2:SUITE 113
Practice Address - City:BRIDGEPORT
Practice Address - State:WV
Practice Address - Zip Code:26330
Practice Address - Country:US
Practice Address - Phone:304-599-8000
Practice Address - Fax:304-599-8003
Is Sole Proprietor?:No
Enumeration Date:2007-09-26
Last Update Date:2020-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV20902080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV3810010249Medicaid