Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RS0012X | Sleep Medicine | M-15166 | ID |
N | 207RS0012X | Sleep Medicine | MD199781 | OR |
N | 2084N0400X | Neurologist | 0600004379 | VT |
N | 2084N0400X | Neurologist | M-15166 | ID |
NPI | 1033504147 |
---|---|
Provider Name | Dr. Aaron Dunham |
First Address | Meridian, ID 83642 |
Second Address | Meridian, ID 83642 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/04/2015 |
Last Update Date | 06/08/2020 |