MEDICARE: DR. AARON WAYNE TUSTIN MD, MPH

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	2083X0100X	Occupational Medicine Physician	D0077628	MD

General Provider Information

NPI Number	:	1336406214
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AARON WAYNE TUSTIN MD, MPH

Provider Business Mailing Address
First Line	:	9334 MELLENBROOK RD
Second Line	:
City	:	COLUMBIA
State	:	MD
Zip	:	21045-1841
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	200 CONSTITUTION AVE NW
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20210-0010
Country	:	US
Telephone Number	:	202-693-2018
Fax Number	:

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

Provider Enumeration Date	:	04/18/2012
Last Update Date	:	08/28/2017

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