Individual
ERIC M PERSILY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3508 STAUNTON AVE SE, CHARLESTON, WV 25304-1477
(304) 925-4086
Mailing address
PO BOX 3444, CHARLESTON, WV 25334-3444
(304) 925-5486
(304) 925-8075
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
17359
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0060418000
—
WV
Enumeration date
07/29/2005
Last updated
11/15/2007
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