Provider Demographics
NPI:1548437148
Name:DOMMU, AARON MATTHEW (MD)
Entity type:Individual
Prefix:DR
First Name:AARON
Middle Name:MATTHEW
Last Name:DOMMU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 CAMBRIDGE DR STE 201
Mailing Address - Street 2:
Mailing Address - City:TRUMBULL
Mailing Address - State:CT
Mailing Address - Zip Code:06611-4763
Mailing Address - Country:US
Mailing Address - Phone:203-335-0195
Mailing Address - Fax:
Practice Address - Street 1:7 CAMBRIDGE DR STE 201
Practice Address - Street 2:
Practice Address - City:TRUMBULL
Practice Address - State:CT
Practice Address - Zip Code:06611-4763
Practice Address - Country:US
Practice Address - Phone:203-335-0195
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-13
Last Update Date:2024-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT048851207R00000X, 207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT12116676Medicaid