Provider Demographics
NPI:1043650302
Name:ROBERTSON, AARON ROY (MD)
Entity Type:Individual
Prefix:DR
First Name:AARON
Middle Name:ROY
Last Name:ROBERTSON
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 1:4671 38TH ST S
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58104-7866
Mailing Address - Country:US
Mailing Address - Phone:701-404-5100
Mailing Address - Fax:701-499-1166
Practice Address - Street 1:4671 38TH ST S
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58104-7866
Practice Address - Country:US
Practice Address - Phone:701-404-5100
Practice Address - Fax:701-499-1166
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-01
Last Update Date:2023-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NDRL12883390200000X
ND13957208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program