Provider Demographics
NPI:1689736019
Name:SALOMON, AARON I (PAC)
Entity Type:Individual
Prefix:MR
First Name:AARON
Middle Name:I
Last Name:SALOMON
Suffix:
Gender:M
Credentials:PAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:918 20TH STREET
Mailing Address - Street 2:
Mailing Address - City:GOTHENBURG
Mailing Address - State:NE
Mailing Address - Zip Code:69138-1237
Mailing Address - Country:US
Mailing Address - Phone:308-537-7131
Mailing Address - Fax:308-537-7310
Practice Address - Street 1:918 20TH STREET
Practice Address - Street 2:
Practice Address - City:GOTHENBURG
Practice Address - State:NE
Practice Address - Zip Code:69138-1237
Practice Address - Country:US
Practice Address - Phone:308-537-7131
Practice Address - Fax:308-537-7310
Is Sole Proprietor?:No
Enumeration Date:2006-12-14
Last Update Date:2012-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE876NE363A00000X
NE876363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE279774Medicare ID - Type Unspecified
P14683Medicare UPIN
NEP14683Medicare PIN