Provider Demographics
NPI:1568084655
Name:SOTOODEH, ARIANA CHERI (PA-C)
Entity Type:Individual
Prefix:
First Name:ARIANA
Middle Name:CHERI
Last Name:SOTOODEH
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:ARIANA
Other - Middle Name:CHERI
Other - Last Name:SOTOODEH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PA-C
Mailing Address - Street 1:936 SHARPE HOSPITAL RD
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:WV
Mailing Address - Zip Code:26452-8550
Mailing Address - Country:US
Mailing Address - Phone:304-269-1210
Mailing Address - Fax:
Practice Address - Street 1:936 SHARPE HOSPITAL RD
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:WV
Practice Address - Zip Code:26452-8550
Practice Address - Country:US
Practice Address - Phone:304-269-1210
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-11
Last Update Date:2021-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV2552363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant