South Charleston Dermatology Pllc in South Charleston - Dermatology
South Charleston Dermatology Pllc - NPI 1174604409
South Charleston Dermatology Pllc is a Dermatology in South Charleston, . South Charleston Dermatology Pllc practices all healthcare services and medical treatments related to Dermatology. The NPI Number for South Charleston Dermatology Pllc is 1174604409. The last update date is 2011-12-12.
South Charleston Dermatology Pllc's current location address is 4815 Kanawha Ave Sw, South Charleston, . You can contact this provider via phone number 3047684567 and fax number 3047682277. The mailing address for South Charleston Dermatology Pllc is 4815 Kanawha Ave Sw, South Charleston, . To know further, please read the information below!
Provider Profile Detail
| Provider Organization | South Charleston Dermatology Pllc |
|---|---|
| Address | 4815 Kanawha Ave Sw, South Charleston, |
| Phone Number | 3047684567 |
| Fax Number | 3047682277 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | OWNER/PHYS |
|---|---|
| Authorized Official Name | Endicott Leigh Michelle |
| Credentials | DO |
| Telephone Number | 3047684567 |
NPI Number Detail
| NPI Number | 1174604409 |
|---|---|
| Provider Enumeration Date | 2006-10-17 |
| Last Updated Date | 2011-12-12 |
Provider Mailing Address Detail
| Address | 4815 Kanawha Ave Sw |
|---|---|
| City | South Charleston |
| State | (WV) |
| Post Code | 253091207 |
| Phone Number | 3047684567 |
| Fax Number | 3047682277 |
Provider's Primary Taxonomy Detail
| Speciality | Dermatology |
|---|---|
| Taxonomy | 207N00000X |
| Licence No | 2097 |
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Definition: A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had |
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What is the unique identifier code issued to South Charleston Dermatology Pllc by the Centers for Medicare & Medicaid Services (CMS)?
The South Charleston Dermatology Pllc has been assigned the NPI (National Provider Identifier) 1174604409. This 10-digit code serves as a unique identification number for healthcare providers, issued by the CMS.
Where is the South Charleston Dermatology Pllc located?
The South Charleston Dermatology Pllc is located at 4815 Kanawha Ave Sw, South Charleston, WV 253091207.
What is South Charleston Dermatology Pllc's specialized field of practice, and what is the corresponding taxonomy code that categorizes this area of expertise?
The area of specialization for South Charleston Dermatology Pllc is Dermatology, and the taxonomy code that classifies this field of practice is 207N00000X.
On what date did the Centers for Medicare & Medicaid Services issue the 1174604409 to South Charleston Dermatology Pllc?
The South Charleston Dermatology Pllc received its 1174604409 assignment from the Centers for Medicare & Medicaid Services on 2006-10-17.
As of what date were the South Charleston Dermatology Pllc's details last updated?
The information pertaining to the South Charleston Dermatology Pllc, including its address, specialty, and other details, was most recently updated on 2011-12-12.