Provider Demographics
NPI:1770665333
Name:CHAMBERLAIN, AARON MARK (MD)
Entity type:Individual
Prefix:DR
First Name:AARON
Middle Name:MARK
Last Name:CHAMBERLAIN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:5848 S FASHION BLVD STE 120
Mailing Address - Street 2:
Mailing Address - City:MURRAY
Mailing Address - State:UT
Mailing Address - Zip Code:84107-6157
Mailing Address - Country:US
Mailing Address - Phone:970-250-2390
Mailing Address - Fax:314-747-2599
Practice Address - Street 1:5848 S FASHION BLVD STE 120
Practice Address - Street 2:
Practice Address - City:MURRAY
Practice Address - State:UT
Practice Address - Zip Code:84107-6157
Practice Address - Country:US
Practice Address - Phone:970-250-2390
Practice Address - Fax:314-747-2599
Is Sole Proprietor?:No
Enumeration Date:2006-10-20
Last Update Date:2024-06-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
UT12860218-1205207X00000X
MO2011003926207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO205666902Medicaid
MO205666902Medicaid