Provider Demographics
NPI:1861758880
Name:OVERLY, AARON (DO)
Entity type:Individual
Prefix:DR
First Name:AARON
Middle Name:
Last Name:OVERLY
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 1:2251 N SQUIRREL RD STE 201B
Mailing Address - Street 2:
Mailing Address - City:AUBURN HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48326-4602
Mailing Address - Country:US
Mailing Address - Phone:313-647-3900
Mailing Address - Fax:
Practice Address - Street 1:2251 N SQUIRREL RD STE 201B
Practice Address - Street 2:
Practice Address - City:AUBURN HILLS
Practice Address - State:MI
Practice Address - Zip Code:48326-4602
Practice Address - Country:US
Practice Address - Phone:313-647-3900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-03
Last Update Date:2023-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
MI5101019913208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program