Healthcare Provider Details

I. General information

NPI: 1639608664
Provider Name (Legal Business Name): AARON RAPP MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/04/2017
Last Update Date: 07/26/2024
Certification Date: 07/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5220 HIGHLAND RD STE 210
WATERFORD MI
48327-1973
US

IV. Provider business mailing address

5220 HIGHLAND RD STE 210
WATERFORD MI
48327-1973
US

V. Phone/Fax

Practice location:
  • Phone: 248-383-1030
  • Fax: 248-383-1031
Mailing address:
  • Phone: 248-383-1030
  • Fax: 248-383-1031

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number4301112687
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberINPROGRESS
License Number StateMI
# 3
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number4301112687
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: