Provider Demographics
NPI:1861635989
Name:GARCIA MERINO, ANTONIO SANTIAGO (MD)
Entity Type:Individual
Prefix:
First Name:ANTONIO
Middle Name:SANTIAGO
Last Name:GARCIA MERINO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:295 BROCKTON LN
Mailing Address - Street 2:
Mailing Address - City:MARTINSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:25403-8370
Mailing Address - Country:US
Mailing Address - Phone:347-756-8380
Mailing Address - Fax:
Practice Address - Street 1:307 MEDICAL CT
Practice Address - Street 2:
Practice Address - City:MARTINSBURG
Practice Address - State:WV
Practice Address - Zip Code:25401-2843
Practice Address - Country:US
Practice Address - Phone:304-260-1436
Practice Address - Fax:304-260-1437
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-20
Last Update Date:2022-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01012536132084P0800X
WV239512084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry