Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | 200400175 | NC |
N | 207NS0135X | Procedural Dermatology | 200400175 | NC |
NPI | 1104873959 |
---|---|
Provider Name | Mr. Aaron Sidscott Wever |
First Address | Concord, NC 28025-1221 |
Second Address | Concord, NC 28025-1221 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/05/2006 |
Last Update Date | 12/02/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
5903853 | (05) | NC |
I53483 | (02) | NC |
P00317703 | MEDICARE RAILROAD (01) | NC |