Individual
ERICK J WILLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
23279
WV
208000000X
Pediatrics Physician
99999
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000000245860
—
OH
01
—
1073527
BRICKSTREET
WV
05
—
2909820
—
OH
05
—
3810012988
—
WV
01
—
6570317
CIGNA
WV
05
—
7100066820
—
KY
01
—
878669
CARELINK
WV
01
—
9865182
AETNA
WV
Enumeration date
05/09/2007
Last updated
04/22/2021
Update your record
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