Provider Demographics
NPI:1407146954
Name:SANTMYIRE, AARON LEE
Entity Type:Individual
Prefix:MR
First Name:AARON
Middle Name:LEE
Last Name:SANTMYIRE
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 1:1812 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:
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?:No
Enumeration Date:2011-04-18
Last Update Date:2011-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV69751363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily