Provider Demographics
NPI:1528025350
Name:SAYRE, AMY PARKER (MD)
Entity Type:Individual
Prefix:DR
First Name:AMY
Middle Name:PARKER
Last Name:SAYRE
Suffix:
Gender:F
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:PO BOX 4406
Mailing Address - Street 2:
Mailing Address - City:CHAPMANVILLE
Mailing Address - State:WV
Mailing Address - Zip Code:25508-4406
Mailing Address - Country:US
Mailing Address - Phone:304-688-9901
Mailing Address - Fax:304-688-9904
Practice Address - Street 1:555 MAIN ST
Practice Address - Street 2:
Practice Address - City:CHAPMANVILLE
Practice Address - State:WV
Practice Address - Zip Code:25508
Practice Address - Country:US
Practice Address - Phone:304-688-9901
Practice Address - Fax:304-688-9904
Is Sole Proprietor?:No
Enumeration Date:2006-04-26
Last Update Date:2012-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV22093207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAMD426633OtherPA LICENSE NUMBER
WV22093OtherLICENSE NUMBER