Individual
ERICA R FRYE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
12 KANAWHA TER, SAINT ALBANS, WV 25177-2750
(304) 201-1130
(304) 201-1134
Mailing address
97 GREAT TEAYS BLVD, SUITE 6, SCOTT DEPOT, WV 25560-9815
(304) 757-6999
(304) 757-3252
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
01316
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001991227
BLUE CROSS BLUE SHIELD
WV
01
—
1072225
WV DWC
WV
01
—
WV0089C
MEDICARE PIN
WV
Enumeration date
09/18/2007
Last updated
01/23/2020
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