Healthcare Provider Details

I. General information

NPI: 1932182474
Provider Name (Legal Business Name): ROGER K. ARONSON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/29/2005
Last Update Date: 10/06/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1415 SAINT FRANCIS AVE
SHAKOPEE MN
55379-3374
US

IV. Provider business mailing address

1415 SAINT FRANCIS AVE
SHAKOPEE MN
55379-3374
US

V. Phone/Fax

Practice location:
  • Phone: 952-993-7750
  • Fax: 952-993-7895
Mailing address:
  • Phone: 952-993-7750
  • Fax: 952-993-7835

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number39723
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: