Provider Demographics
NPI:1275865123
Name:KISTLER, AARON M (MD)
Entity Type:Individual
Prefix:DR
First Name:AARON
Middle Name:M
Last Name:KISTLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:3289 WOODBURN RD STE 60
Mailing Address - Street 2:
Mailing Address - City:ANNANDALE
Mailing Address - State:VA
Mailing Address - Zip Code:22003-7337
Mailing Address - Country:US
Mailing Address - Phone:703-698-9573
Mailing Address - Fax:703-698-1592
Practice Address - Street 1:3289 WOODBURN RD STE 60
Practice Address - Street 2:
Practice Address - City:ANNANDALE
Practice Address - State:VA
Practice Address - Zip Code:22003-7337
Practice Address - Country:US
Practice Address - Phone:703-698-9573
Practice Address - Fax:703-698-1592
Is Sole Proprietor?:No
Enumeration Date:2010-02-03
Last Update Date:2010-02-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101035830207U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207U00000XAllopathic & Osteopathic PhysiciansNuclear Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KI631097Medicare PIN
E60105Medicare UPIN