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NPI Code Detail

MEDICARE: CARY SKIN CENTER, PA

MEDICARE: CARY SKIN CENTER, PA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207ND0101XMOHS-Micrographic Surgery Physician81706NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
130557OTHERNCWELLPATH
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
301603OTHERNCBCBS

General Provider Information

NPI Number : 1902869530
Entity Type Code : Organization
Provider Name (Legal Business Name) : CARY SKIN CENTER, PA
Provider Business Mailing Address
First Line : 200 WELLESLEY TRADE LN
Second Line :
City : CARY
State : NC
Zip : 27519-5576
Country : US
Telephone Number : 919-363-7546
Fax Number : 919-363-3616
Provider Business Practice Location Address
First Line : 200 WELLESLEY TRADE LN
Second Line :
City : CARY
State : NC
Zip : 27519-5576
Country : US
Telephone Number : 919-363-7546
Fax Number : 919-363-3616
Authorized Official
Title or Position : PRESIDENT
Name : ROBERT E CLARK
Credential : MD, PHD
Telephone Number : 919-363-7546
Provider Enumeration Date : 04/06/2006
Last Update Date : 04/28/2020

Similar Medicare Providers

1982600789 — DR. ROBERT EARL CLARK M.D., PHD
Practice Location Address:
200 WELLESLEY TRADE LN
CARY, NC
27519-5576
Practice Phone: 919-363-7546
Practice Fax: 919-363-3616
1154302610 — TIMOTHY CORCORAN FLYNN M.D.
Practice Location Address:
200 WELLESLEY TRADE LN
CARY, NC
27519-5576
Practice Phone: 919-363-7546
Practice Fax: 919-363-3616
1225066426 — MS. HEATHER L AMITRONE PA-C
Practice Location Address:
200 WELLESLEY TRADE LN
CARY, NC
27519-5576
Practice Phone: 919-363-7546
Practice Fax: 919-363-3616
1356424501 — DAN ECCLESTONE PA-C
Practice Location Address:
200 WELLESLEY TRADE LN
CARY, NC
27519-5576
Practice Phone: 919-363-7546
Practice Fax: 919-363-3616
1619035946 — PAUL STEPHEN TOTH P.A.
Practice Location Address:
200 WELLESLEY TRADE LN
CARY, NC
27519-5576
Practice Phone: 919-363-7546
Practice Fax: 919-363-3616
1265699649 — STEVE ADDISON WATSON PA-C
Practice Location Address:
200 WELLESLEY TRADE LN
CARY, NC
27519-5576
Practice Phone: 919-363-7546
Practice Fax: 919-363-3616

Directions to “CARY SKIN CENTER, PA ” Practice Location

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