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General NPI Number Information
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NPI Number | 1033195789
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Entity Type | Organization
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Legal Business Name | DERMATOLOGY SPECIALISTS PA
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Dates
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Enumeration Date | 12/15/2005
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Last Update Date | 06/28/2022
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Provider Practice Location Address
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Address Line | 4527 JESSUP GROVE RD
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City | GREENSBORO
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State | NC
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Zip | 27410-9407
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Country | US
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Telephone | 336-632-9272
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Fax | 866-554-1610
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Provider Business Mailing Address
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Address Line | 4527 JESSUP GROVE RD
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City | GREENSBORO
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State | NC
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Zip | 27410-9407
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Country | US
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Telephone | 336-632-9272
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Fax | 866-554-1610
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | SUSAN ARMSTRONG
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Credential |
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Telephone | 336-632-9272
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number |
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License Number State |
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