Provider Demographics
NPI:1164409942
Name:AARON, MAUREEN M (MD)
Entity Type:Individual
Prefix:DR
First Name:MAUREEN
Middle Name:M
Last Name:AARON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:314 FAIRY STREET EXT
Mailing Address - Street 2:SUITE A
Mailing Address - City:MARTINSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24112-1913
Mailing Address - Country:US
Mailing Address - Phone:276-638-8692
Mailing Address - Fax:276-638-3389
Practice Address - Street 1:314 FAIRY STREET EXT
Practice Address - Street 2:SUITE A
Practice Address - City:MARTINSVILLE
Practice Address - State:VA
Practice Address - Zip Code:24112-1913
Practice Address - Country:US
Practice Address - Phone:276-638-8692
Practice Address - Fax:276-638-3389
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-22
Last Update Date:2011-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101036310207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA173711OtherBLACK LUNG PROVIDER NUMBE
VA080190378OtherRAILROAD MEDICARE PROVIDE
VA292529OtherANTHEM PROVIDER NUMBER
VA5645069Medicaid
VA080190378OtherRAILROAD MEDICARE PROVIDE
VA1164409942Medicare PIN