Provider Demographics
NPI:1124119771
Name:VITUG, ANGELIQUE FERRER (MD)
Entity type:Individual
Prefix:
First Name:ANGELIQUE
Middle Name:FERRER
Last Name:VITUG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2308
Mailing Address - Street 2:
Mailing Address - City:CLARKSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:26302-2308
Mailing Address - Country:US
Mailing Address - Phone:304-624-2224
Mailing Address - Fax:304-624-2787
Practice Address - Street 1:1 HOSPITAL PLZ
Practice Address - Street 2:
Practice Address - City:CLARKSBURG
Practice Address - State:WV
Practice Address - Zip Code:26301-9215
Practice Address - Country:US
Practice Address - Phone:304-624-2224
Practice Address - Fax:304-624-2787
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2021-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program