Healthcare Provider Details

I. General information

NPI: 1396852281
Provider Name (Legal Business Name): AARON ZACHARY HETTINGER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2006
Last Update Date: 06/21/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 IRVING ST NW SUITE NA-1177
WASHINGTON DC
20010-3017
US

IV. Provider business mailing address

110 IRVING ST NW SUITE NA-1177
WASHINGTON DC
20010-3017
US

V. Phone/Fax

Practice location:
  • Phone: 202-877-2525
  • Fax: 202-877-9263
Mailing address:
  • Phone: 202-877-2525
  • Fax: 202-877-9263

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberMD038665
License Number StateDC
# 2
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberD72492
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: