Provider Demographics
NPI:1760641740
Name:BOSTER, AARON LEE (MD)
Entity Type:Individual
Prefix:DR
First Name:AARON
Middle Name:LEE
Last Name:BOSTER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:8000 RAVINES EDGE CT STE 200
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43235-5422
Mailing Address - Country:US
Mailing Address - Phone:614-304-3444
Mailing Address - Fax:614-304-3433
Practice Address - Street 1:8000 RAVINES EDGE CT STE 200
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43235-5422
Practice Address - Country:US
Practice Address - Phone:614-304-3444
Practice Address - Fax:614-304-3433
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-05
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH350916262084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2917035Medicaid
OH2917035Medicaid
H417030Medicare PIN