Basic Information
| Provider Information | |||||||||
| NPI: | 1457557118 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | QUEEN | ||||||||
| FirstName: | AARIC | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7231 LIFE QUEST LN | ||||||||
| Address2: | |||||||||
| City: | COLUMBIA | ||||||||
| State: | MD | ||||||||
| PostalCode: | 210455253 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4102905987 | ||||||||
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| Practice Location | |||||||||
| Address1: | WRAMC, BLDG 2, 2J38 | ||||||||
| Address2: | 6900 GEORGIA AVE, NW | ||||||||
| City: | WASHINGTON | ||||||||
| State: | DC | ||||||||
| PostalCode: | 20307 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2027820039 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/21/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | MD -14272 | HI | Y | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.