Healthcare Provider Details

I. General information

NPI: 1366547739
Provider Name (Legal Business Name): MICHAEL JAY AARONSON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/13/2006
Last Update Date: 01/15/2021
Certification Date: 01/15/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

77 HERRICK ST
BEVERLY MA
01915-2734
US

IV. Provider business mailing address

77 HERRICK ST
BEVERLY MA
01915-2734
US

V. Phone/Fax

Practice location:
  • Phone: 978-927-4110
  • Fax: 978-232-7056
Mailing address:
  • Phone: 978-927-4110
  • Fax: 978-232-7056

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number43761
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: