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General NPI Number Information
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NPI Number | 1215575238
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Entity Type | Organization
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Legal Business Name | POLARIS SKIN DIAGNOSTICS, LLC
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Dates
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Enumeration Date | 12/20/2019
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Last Update Date | 11/12/2025
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Provider Practice Location Address
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Address Line | 8170 ROURK STREET SUITE 100
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City | MYRTLE BEACH
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State | SC
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Zip | 29572
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Country | US
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Telephone | 917-756-0188
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Fax |
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Provider Business Mailing Address
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Address Line | 8170 ROURK ST STE 100
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City | MYRTLE BEACH
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State | SC
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Zip | 29572-4127
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Country | US
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Telephone | 843-282-1915
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Fax | 843-839-1812
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Authorized Official
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Title or Position | OWNER
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Name | STEPHEN B HAMMOND
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Credential | MD
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Telephone | 917-756-0188
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ND0900X
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Taxonomy Name | Dermatopathology Physician
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License Number |
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License Number State |
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