Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | 21088 | WV |
NPI | 1033114715 |
---|---|
Provider Name | Dr. Beth Renee Santmyire-Rosenberger |
First Address | Fairmont, WV 26554-1216 |
Second Address | Fairmont, WV 26554-1216 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/06/2005 |
Last Update Date | 26/06/2015 |