Provider Demographics
NPI:1013228113
Name:HOLSINGER, AARON L (MD)
Entity Type:Individual
Prefix:DR
First Name:AARON
Middle Name:L
Last Name:HOLSINGER
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 1:13960 W WAINWRIGHT DR
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83713-1969
Mailing Address - Country:US
Mailing Address - Phone:208-947-5390
Mailing Address - Fax:208-947-3465
Practice Address - Street 1:13960 W WAINWRIGHT DR
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83713-1969
Practice Address - Country:US
Practice Address - Phone:208-947-5390
Practice Address - Fax:208-947-3465
Is Sole Proprietor?:No
Enumeration Date:2010-06-24
Last Update Date:2013-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01070107A207P00000X
IN11015695A207P00000X
IDM-12044207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN201075660Medicaid
IDM12044OtherMEDICAL LICENSE
IDM12044OtherMEDICAL LICENSE
INP01106111Medicare PIN