Provider Demographics
NPI:1023645942
Name:FRIGOLETTO, EVAN MICHAEL (MD)
Entity type:Individual
Prefix:
First Name:EVAN
Middle Name:MICHAEL
Last Name:FRIGOLETTO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:678 KILLARNEY DR APT 2
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26505-2449
Mailing Address - Country:US
Mailing Address - Phone:304-602-7736
Mailing Address - Fax:
Practice Address - Street 1:1 MEDICAL CENTER DR
Practice Address - Street 2:
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26506-1200
Practice Address - Country:US
Practice Address - Phone:304-598-4820
Practice Address - Fax:304-598-6829
Is Sole Proprietor?:No
Enumeration Date:2020-03-23
Last Update Date:2025-02-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WV33791207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology