Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207P00000X | Emergency Physician | 01070107A | IN |
N | 207P00000X | Emergency Physician | 11015695A | IN |
Y | 207P00000X | Emergency Physician | M-12044 | ID |
NPI | 1013228113 |
---|---|
Provider Name | Dr. Aaron L. Holsinger |
First Address | Boise, ID 83713-1969 |
Second Address | Boise, ID 83713-1969 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/06/2010 |
Last Update Date | 19/07/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
201075660 | (05) | IN |
M12044 | MEDICAL LICENSE (01) | ID |