Provider Demographics
NPI:1164780656
Name:WILSON, AARON THOMAS (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:AARON
Middle Name:THOMAS
Last Name:WILSON
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3520 EASTOVER RIDGE DR
Mailing Address - Street 2:APARTMENT 1101
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28211-1576
Mailing Address - Country:US
Mailing Address - Phone:412-600-2376
Mailing Address - Fax:
Practice Address - Street 1:1400 MAIN ST APT 245
Practice Address - Street 2:
Practice Address - City:CANONSBURG
Practice Address - State:PA
Practice Address - Zip Code:15317-6818
Practice Address - Country:US
Practice Address - Phone:412-600-2376
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-02
Last Update Date:2023-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC22315183500000X
PARP448438183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist