Individual
ANGELA BETH FERGUSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
301-6 GREAT TEAYS BLVD, SCOTT DEPOT, WV 25560
(304) 757-6999
(304) 757-3252
Mailing address
301-6 GREAT TEAYS BLVD, SCOTT DEPOT, WV 25560
(304) 757-6999
(304) 757-3252
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
20603
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001721959
MS BCBS
WV
05
—
1807628000
—
WV
01
—
7623269
AETNA
WV
Enumeration date
01/06/2006
Last updated
12/27/2011
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