Provider Demographics
NPI:1164118998
Name:MCDANIEL, AARON
Entity Type:Individual
Prefix:
First Name:AARON
Middle Name:
Last Name:MCDANIEL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 HUMANITARIAN WAY
Mailing Address - Street 2:
Mailing Address - City:MARTINSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:25401-2318
Mailing Address - Country:US
Mailing Address - Phone:681-260-2578
Mailing Address - Fax:
Practice Address - Street 1:104 HUMANITARIAN WAY
Practice Address - Street 2:
Practice Address - City:MARTINSBURG
Practice Address - State:WV
Practice Address - Zip Code:25401-2318
Practice Address - Country:US
Practice Address - Phone:681-260-2578
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-14
Last Update Date:2023-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver