Healthcare Provider Details

I. General information

NPI: 1043478761
Provider Name (Legal Business Name): ARON JEFFREY GEWIRTZMAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/29/2008
Last Update Date: 06/06/2024
Certification Date: 06/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1705 GARDNER ROAD
WILMINGTON NC
28405
US

IV. Provider business mailing address

1705 GARDNER ROAD
WILMINGTON NC
28405
US

V. Phone/Fax

Practice location:
  • Phone: 910-343-5300
  • Fax:
Mailing address:
  • Phone: 910-343-5300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberM8669
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: