Provider Demographics
NPI:1730390212
Name:ARONOV, MARK MICHAILOVICH (DO)
Entity type:Individual
Prefix:DR
First Name:MARK
Middle Name:MICHAILOVICH
Last Name:ARONOV
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6525 W MAPLE RD STE 101E
Mailing Address - Street 2:
Mailing Address - City:WEST BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48322-4302
Mailing Address - Country:US
Mailing Address - Phone:248-960-4245
Mailing Address - Fax:248-960-4465
Practice Address - Street 1:6525 W MAPLE RD STE 101E
Practice Address - Street 2:
Practice Address - City:WEST BLOOMFIELD
Practice Address - State:MI
Practice Address - Zip Code:48322-4302
Practice Address - Country:US
Practice Address - Phone:248-960-4245
Practice Address - Fax:248-960-4465
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-25
Last Update Date:2023-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101016890207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine