Healthcare Provider Details

I. General information

NPI: 1023457132
Provider Name (Legal Business Name): AARON MARTIN VER HEUL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/21/2013
Last Update Date: 04/17/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1110 HIGHLANDS PLAZA DR E DIV IM ALLERGY AND IMMUNOLOGY, STE 300
SAINT LOUIS MO
63110-1392
US

IV. Provider business mailing address

PO BOX 7412011
CHICAGO IL
60674-2011
US

V. Phone/Fax

Practice location:
  • Phone: 314-996-8670
  • Fax: 866-362-4984
Mailing address:
  • Phone: 314-996-8670
  • Fax: 866-362-4984

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RA0201X
TaxonomyAllergy & Immunology (Internal Medicine) Physician
License Number2015008633
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number2015008633
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: