MEDICARE: DR. AARON M. KISTLER MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207U00000X	Nuclear Medicine Physician	0101035830	VA

General Provider Information

NPI Number	:	1275865123
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AARON M. KISTLER MD

Provider Business Mailing Address
First Line	:	3289 WOODBURN RD STE 60
Second Line	:
City	:	ANNANDALE
State	:	VA
Zip	:	22003-7337
Country	:	US
Telephone Number	:	703-698-9573
Fax Number	:	703-698-1592

Provider Business Practice Location Address
First Line	:	3289 WOODBURN RD STE 60
Second Line	:
City	:	ANNANDALE
State	:	VA
Zip	:	22003-7337
Country	:	US
Telephone Number	:	703-698-9573
Fax Number	:	703-698-1592

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/03/2010
Last Update Date	:	02/03/2010

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