Provider Demographics
NPI:1528625589
Name:FANKHANEL, ERIN BETH (MD)
Entity type:Individual
Prefix:DR
First Name:ERIN
Middle Name:BETH
Last Name:FANKHANEL
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 1680
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:25717-1680
Mailing Address - Country:US
Mailing Address - Phone:304-781-5151
Mailing Address - Fax:304-523-0115
Practice Address - Street 1:408 ALEXANDER ST
Practice Address - Street 2:
Practice Address - City:CEDAR GROVE
Practice Address - State:WV
Practice Address - Zip Code:25039
Practice Address - Country:US
Practice Address - Phone:304-595-1770
Practice Address - Fax:304-595-3298
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-24
Last Update Date:2023-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCLL82547207R00000X
PAMD477931207R00000X
WV32326207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine