Provider Demographics
NPI:1861488926
Name:ARONBERG, JEROME M (MD)
Entity Type:Individual
Prefix:DR
First Name:JEROME
Middle Name:M
Last Name:ARONBERG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:141 N MERAMEC AVE SUITE 315
Mailing Address - Street 2:
Mailing Address - City:CLAYTON
Mailing Address - State:MO
Mailing Address - Zip Code:63105-3750
Mailing Address - Country:US
Mailing Address - Phone:314-862-6221
Mailing Address - Fax:314-863-9031
Practice Address - Street 1:141 N MERAMEC AVE SUITE 315
Practice Address - Street 2:
Practice Address - City:CLAYTON
Practice Address - State:MO
Practice Address - Zip Code:63105-3750
Practice Address - Country:US
Practice Address - Phone:314-862-6221
Practice Address - Fax:314-863-9031
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-23
Last Update Date:2007-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR5056207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
A09828Medicare UPIN