Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 2015008633 | MO |
N | 111NI0900X | Internist | 2015008633 | MO |
Y | 207RA0201X | Internist - Allergy & Immunology | 2015008633 | MO |
NPI | 1023457132 |
---|---|
Provider Name | Dr. Aaron Martin Ver Heul |
First Address | Saint Louis, MO 63110-1010 |
Second Address | Saint Louis, MO 63110-1392 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/06/2013 |
Last Update Date | 25/01/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
200059776 | (05) | MO |