Provider Demographics
NPI:1932182474
Name:ARONSON, ROGER K (MD)
Entity Type:Individual
Prefix:DR
First Name:ROGER
Middle Name:K
Last Name:ARONSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1415 SAINT FRANCIS AVE
Mailing Address - Street 2:
Mailing Address - City:SHAKOPEE
Mailing Address - State:MN
Mailing Address - Zip Code:55379-3374
Mailing Address - Country:US
Mailing Address - Phone:952-993-7750
Mailing Address - Fax:952-993-7835
Practice Address - Street 1:1415 SAINT FRANCIS AVE
Practice Address - Street 2:
Practice Address - City:SHAKOPEE
Practice Address - State:MN
Practice Address - Zip Code:55379-3374
Practice Address - Country:US
Practice Address - Phone:952-993-7750
Practice Address - Fax:952-993-7895
Is Sole Proprietor?:No
Enumeration Date:2005-11-29
Last Update Date:2011-10-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN39723208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN866650400Medicaid
MN866650400Medicaid