Provider Demographics
NPI:1598902314
Name:GREENE, AARON CHARLES (PA)
Entity Type:Individual
Prefix:
First Name:AARON
Middle Name:CHARLES
Last Name:GREENE
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 1:8015 PLEASANTVIEW WOODS CIR
Mailing Address - Street 2:
Mailing Address - City:HARBOR SPRINGS
Mailing Address - State:MI
Mailing Address - Zip Code:49740-8528
Mailing Address - Country:US
Mailing Address - Phone:231-330-2749
Mailing Address - Fax:
Practice Address - Street 1:8015 PLEASANTVIEW WOODS CIR
Practice Address - Street 2:
Practice Address - City:HARBOR SPRINGS
Practice Address - State:MI
Practice Address - Zip Code:49740-8528
Practice Address - Country:US
Practice Address - Phone:231-330-2749
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-01-15
Last Update Date:2022-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5601005463363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant