Provider Demographics
NPI:1194010561
Name:FAIN, AARON DAVID (MD)
Entity type:Individual
Prefix:DR
First Name:AARON
Middle Name:DAVID
Last Name:FAIN
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 1:3448 US ROUTE 60
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:25705-2906
Mailing Address - Country:US
Mailing Address - Phone:304-522-1550
Mailing Address - Fax:304-522-0704
Practice Address - Street 1:3448 US ROUTE 60
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:WV
Practice Address - Zip Code:25705-2906
Practice Address - Country:US
Practice Address - Phone:304-522-1550
Practice Address - Fax:304-522-0704
Is Sole Proprietor?:No
Enumeration Date:2011-06-14
Last Update Date:2024-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY492542085R0202X
OH35.1508692085R0202X
WV337862085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV1194010561Medicaid
KY7100268700Medicaid
OH0472826Medicaid