Healthcare Provider Details

I. General information

NPI: 1194831057
Provider Name (Legal Business Name): AARON J NOTESTINE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/22/2006
Last Update Date: 07/28/2025
Certification Date: 07/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 W IRONWOOD DR STE 350
COEUR D ALENE ID
83814-4487
US

IV. Provider business mailing address

2003 KOOTENAI HEALTH WAY
COEUR D ALENE ID
83814-6051
US

V. Phone/Fax

Practice location:
  • Phone: 208-625-5250
  • Fax: 208-625-5251
Mailing address:
  • Phone: 208-625-5085
  • Fax: 208-625-5731

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberM-12520
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: