Provider Demographics
NPI:1033114715
Name:SANTMYIRE-ROSENBERGER, BETH RENEE (MD PHD)
Entity Type:Individual
Prefix:DR
First Name:BETH
Middle Name:RENEE
Last Name:SANTMYIRE-ROSENBERGER
Suffix:
Gender:F
Credentials:MD PHD
Other - Prefix:
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Mailing Address - Street 1:1812 COUNTRY CLUB RD
Mailing Address - Street 2:
Mailing Address - City:FAIRMONT
Mailing Address - State:WV
Mailing Address - Zip Code:26554-1216
Mailing Address - Country:US
Mailing Address - Phone:304-368-0111
Mailing Address - Fax:304-368-0411
Practice Address - Street 1:1812 COUNTRY CLUB RD
Practice Address - Street 2:STE 201
Practice Address - City:FAIRMONT
Practice Address - State:WV
Practice Address - Zip Code:26554-1216
Practice Address - Country:US
Practice Address - Phone:304-368-0111
Practice Address - Fax:304-368-0411
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-17
Last Update Date:2015-06-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WV21088207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology