MEDICARE: DR. AMY PARKER SAYRE MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	22093	WV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MD426633	OTHER	PA	PA LICENSE NUMBER
2	22093	OTHER	WV	LICENSE NUMBER

General Provider Information

NPI Number	:	1528025350
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AMY PARKER SAYRE MD

Provider Business Mailing Address
First Line	:	PO BOX 4406
Second Line	:
City	:	CHAPMANVILLE
State	:	WV
Zip	:	25508-4406
Country	:	US
Telephone Number	:	304-688-9901
Fax Number	:	304-688-9904

Provider Business Practice Location Address
First Line	:	555 MAIN ST
Second Line	:
City	:	CHAPMANVILLE
State	:	WV
Zip	:	25508
Country	:	US
Telephone Number	:	304-688-9901
Fax Number	:	304-688-9904

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/26/2006
Last Update Date	:	04/26/2012

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