Healthcare Provider Details

I. General information

NPI: 1316523798
Provider Name (Legal Business Name): ARON STARK MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2021
Last Update Date: 07/09/2024
Certification Date: 07/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 MICHIGAN AVE NW
WASHINGTON DC
20010-2916
US

IV. Provider business mailing address

3333 BURNET AVE # MLC5018
CINCINNATI OH
45229-3026
US

V. Phone/Fax

Practice location:
  • Phone: 888-884-2327
  • Fax:
Mailing address:
  • Phone: 513-636-4315
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD500003169
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: