Enrico-Simon, Agnes A
Enrico-Simon, Agnes A is an sole proprietor health care provider with primary practice located at 2420 Jefferson Ave , Pt Pleasant WV 25550-1528. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Enrico-Simon, Agnes A can be contacted via phone (304) 675-6817.Contact Information
Primary practice address
2420 Jefferson Ave
Pt Pleasant WV 25550-1528
Phone: (304) 675-6817
Fax: (304) 675-5893
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 20514 | West Virginia |
Profile Details
| NPI number | 1003910670 |
|---|---|
| LBN Legal business name | Enrico-Simon, Agnes A |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 12th, 2006 |
| Last updated | Feb 19th, 2024 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1003910670 | NPPES |
| Ohio | MEDICAID | 2362269 | |
| Ohio | Other | 001723700 | |
| Ohio | MEDICAID | 3002914000 | |
| Ohio | Other | 7133291 |
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