# AARON J DERRY

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1093755886
- **Gender:** Man
- **Credential:** PAC

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363A00000X | Physician Assistant | MED-PAC-LIC-402 | MT | Yes |
| 363AM0700X | Medical Physician Assistant | 402 | MT | — |
| 363AS0400X | Surgical Physician Assistant | 402 | MT | — |

## Other

- **Enumeration date:** 06/08/2006
- **Last updated:** 05/24/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 4304287 | — | MT |