Provider Demographics
NPI:1417044058
Name:AESTHETIC SOLUTIONS PA
Entity Type:Organization
Organization Name:AESTHETIC SOLUTIONS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SUE
Authorized Official - Middle Name:ELLEN
Authorized Official - Last Name:COX
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:919-403-6200
Mailing Address - Street 1:5821 FARRINGTON RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27517-9901
Mailing Address - Country:US
Mailing Address - Phone:919-403-6200
Mailing Address - Fax:919-403-6242
Practice Address - Street 1:5821 FARRINGTON RD
Practice Address - Street 2:SUITE 101
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27517-9901
Practice Address - Country:US
Practice Address - Phone:919-403-6200
Practice Address - Fax:919-403-6242
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-06
Last Update Date:2015-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC82603207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0235HOtherBCBS
NC891143JMedicaid
NCF44082OtherUPIN
NC1043311632OtherNPI-WAGONER
NC4420282OtherAETNA
NCE67095OtherUPIN
NC1619940913OtherNPI-COX
NC1043311632OtherNPI-WAGONER
NC1619940913OtherNPI-COX