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General NPI Number Information
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NPI Number | 1114378676
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Entity Type | Individual
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Provider Name | AARON MICHAEL WASSON MD
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Gender | Male
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Dates
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Enumeration Date | 06/27/2016
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Last Update Date | 07/27/2022
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Provider Practice Location Address
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Address Line | 5200 FAIRVIEW BLVD
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City | WYOMING
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State | MN
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Zip | 55092-8013
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Country | US
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Telephone | 612-672-6999
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 110429
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City | AURORA
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State | CO
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Zip | 80042-0429
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | R10711
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License Number State | IA
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Taxonomy #2
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | DR.0062147
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License Number State | CO
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Taxonomy #3
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | 72111
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License Number State | MN
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