Healthcare Provider Details

I. General information

NPI: 1023316825
Provider Name (Legal Business Name): ARON PRIMACK MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/03/2011
Last Update Date: 03/03/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1217 EDGEVALE RD
SILVER SPRING MD
20910-1612
US

IV. Provider business mailing address

1217 EDGEVALE RD
SILVER SPRING MD
20910-1612
US

V. Phone/Fax

Practice location:
  • Phone: 301-565-3094
  • Fax:
Mailing address:
  • Phone: 301-565-3094
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License NumberD0016507
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: