Provider Demographics
NPI:1558993303
Name:FREDETTE, AARON CHARLES (PA)
Entity Type:Individual
Prefix:MR
First Name:AARON
Middle Name:CHARLES
Last Name:FREDETTE
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:627 MIDDLE CT APT 6
Mailing Address - Street 2:
Mailing Address - City:CHELSEA
Mailing Address - State:MI
Mailing Address - Zip Code:48118-2302
Mailing Address - Country:US
Mailing Address - Phone:734-474-5882
Mailing Address - Fax:
Practice Address - Street 1:1301 S MAIN ST
Practice Address - Street 2:
Practice Address - City:CHELSEA
Practice Address - State:MI
Practice Address - Zip Code:48118-1418
Practice Address - Country:US
Practice Address - Phone:517-577-6418
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-10
Last Update Date:2021-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant