Provider Demographics
NPI:1144217399
Name:KIRKEMO, AARON KURTISS (MD)
Entity Type:Individual
Prefix:
First Name:AARON
Middle Name:KURTISS
Last Name:KIRKEMO
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2550 UNIVERSITY AVE W
Mailing Address - Street 2:SUITE 240N
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55114-1052
Mailing Address - Country:US
Mailing Address - Phone:651-999-6909
Mailing Address - Fax:651-297-6115
Practice Address - Street 1:1655 BEAM AVE
Practice Address - Street 2:SUITE 206
Practice Address - City:MAPLEWOOD
Practice Address - State:MN
Practice Address - Zip Code:55109-1163
Practice Address - Country:US
Practice Address - Phone:651-999-6896
Practice Address - Fax:651-770-8268
Is Sole Proprietor?:No
Enumeration Date:2005-10-03
Last Update Date:2008-05-29
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Provider Licenses
StateLicense IDTaxonomies
MN40978208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN795013600Medicaid
MNA47379Medicare UPIN
MN795013600Medicaid