| Agnes A Enrico-simon, Pllc | |
|
2415 Jackson Ave Pt Pleasant WV 25550-2042 | |
| (304) 675-6090 | |
| (304) 675-5893 |
| Full Name | Agnes A Enrico-simon, Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 2415 Jackson Ave, Pt Pleasant, West Virginia |
| Authorized Official Name and Position | Agnes A Enrico-simon (PHYSICIAN) |
| Authorized Official Contact | 3046756817 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Agnes A Enrico-simon, Pllc 2415 Jackson Ave Pt Pleasant WV 25550-2042 Ph: (304) 675-6090 | Agnes A Enrico-simon, Pllc 2415 Jackson Ave Pt Pleasant WV 25550-2042 Ph: (304) 675-6090 |
| NPI Number | 1386846707 |
|---|---|
| Provider Enumeration Date | 06/05/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386846707 | NPI | - | NPPES |
| 3002914000 | Medicaid | WV |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (West Virginia) | Primary |
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