Provider Demographics
NPI:1952633976
Name:ARONBERG, TARA KATHLEEN (PA)
Entity Type:Individual
Prefix:MS
First Name:TARA
Middle Name:KATHLEEN
Last Name:ARONBERG
Suffix:
Gender:F
Credentials:PA
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Mailing Address - Street 1:PO BOX 60352
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63160-0352
Mailing Address - Country:US
Mailing Address - Phone:314-362-8483
Mailing Address - Fax:314-300-0835
Practice Address - Street 1:1044 N MASON RD
Practice Address - Street 2:DEPT ORTHOPAEDIC SURGERY, STE 110/210
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63141-6431
Practice Address - Country:US
Practice Address - Phone:314-362-8483
Practice Address - Fax:314-300-0835
Is Sole Proprietor?:No
Enumeration Date:2010-02-01
Last Update Date:2024-04-10
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Provider Licenses
StateLicense IDTaxonomies
MO2010005185363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO220026646Medicaid