Healthcare Provider Details

I. General information

NPI: 1164051777
Provider Name (Legal Business Name): AARON LAURENCE MAUNER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/06/2020
Last Update Date: 06/18/2024
Certification Date: 06/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1120 WELLINGTON AVE STE 206
GRAND JUNCTION CO
81501-6131
US

IV. Provider business mailing address

11836 E KEPNER DR
AURORA CO
80012-3292
US

V. Phone/Fax

Practice location:
  • Phone: 970-243-7245
  • Fax:
Mailing address:
  • Phone: 303-818-9359
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberDR.0073452
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: