Provider Demographics
NPI: | 1124040308 |
---|---|
Name: | DUMONT, AARON S (MD) |
Entity Type: | Individual |
Prefix: | DR |
First Name: | AARON |
Middle Name: | S |
Last Name: | DUMONT |
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: | 131 S ROBERTSON ST |
Mailing Address - Street 2: | SUITE 1300 |
Mailing Address - City: | NEW ORLEANS |
Mailing Address - State: | LA |
Mailing Address - Zip Code: | 70112-2807 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 504-988-5565 |
Mailing Address - Fax: | 504-988-5793 |
Practice Address - Street 1: | 131 S ROBERTSON ST |
Practice Address - Street 2: | SUITE 1300 |
Practice Address - City: | NEW ORLEANS |
Practice Address - State: | LA |
Practice Address - Zip Code: | 70112-2807 |
Practice Address - Country: | US |
Practice Address - Phone: | 504-988-5565 |
Practice Address - Fax: | 504-988-5793 |
Is Sole Proprietor?: | No |
Enumeration Date: | 2006-07-24 |
Last Update Date: | 2017-06-16 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
VA | 0101239907 | 207T00000X |
PA | MD439010 | 207T00000X |
NJ | 25MA08803500 | 207T00000X |
LA | MD.205983 | 207T00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 207T00000X | Allopathic & Osteopathic Physicians | Neurological Surgery |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
PA | 102494842 | Medicaid | |
NJ | 0238783 | Medicaid | |
NJ | 0238783 | Medicaid | |
PA | 102494842 | Medicaid |