Healthcare Provider Details

I. General information

NPI: 1417044058
Provider Name (Legal Business Name): AESTHETIC SOLUTIONS PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2006
Last Update Date: 06/10/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5821 FARRINGTON RD SUITE 101
CHAPEL HILL NC
27517-9901
US

IV. Provider business mailing address

5821 FARRINGTON RD SUITE 101
CHAPEL HILL NC
27517-9901
US

V. Phone/Fax

Practice location:
  • Phone: 919-403-6200
  • Fax: 919-403-6242
Mailing address:
  • Phone: 919-403-6200
  • Fax: 919-403-6242

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number82603
License Number StateNC

VIII. Authorized Official

Name: DR. SUE ELLEN COX
Title or Position: PRESIDENT
Credential: MD
Phone: 919-403-6200