Provider Demographics
NPI:1083905657
Name:BUTERBAUGH, AARON WADE (RPH)
Entity Type:Individual
Prefix:
First Name:AARON
Middle Name:WADE
Last Name:BUTERBAUGH
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:217 BEACON DR
Mailing Address - Street 2:
Mailing Address - City:WEIRTON
Mailing Address - State:WV
Mailing Address - Zip Code:26062-4903
Mailing Address - Country:US
Mailing Address - Phone:304-224-1603
Mailing Address - Fax:
Practice Address - Street 1:4402 SUNSET BLVD
Practice Address - Street 2:
Practice Address - City:STEUBENVILLE
Practice Address - State:OH
Practice Address - Zip Code:43952-3423
Practice Address - Country:US
Practice Address - Phone:740-264-0611
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-29
Last Update Date:2011-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03329036183500000X
PARP045404R183500000X
VA0202012513183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist