Healthcare Provider Details

I. General information

NPI: 1043207442
Provider Name (Legal Business Name): AIDA M LUGO-SOMOLINOS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/30/2005
Last Update Date: 04/08/2021
Certification Date: 04/08/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3100 THURSTON-BOWLES UNC CB#7287
CHAPEL HILL NC
27599-7287
US

IV. Provider business mailing address

3100 THURSTON-BOWLES BLDG UNC CB#7287
CHAPEL HILL NC
27599
US

V. Phone/Fax

Practice location:
  • Phone: 919-843-9447
  • Fax:
Mailing address:
  • Phone: 919-843-9447
  • Fax: 919-966-3898

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number8329
License Number StatePR
# 2
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number200700631
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: