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General NPI Number Information
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NPI Number | 1316968639
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Entity Type | Organization
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Legal Business Name | KULP DERMATOLOGY P.A.
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Dates
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Enumeration Date | 07/21/2006
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Last Update Date | 04/12/2016
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Provider Practice Location Address
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Address Line | 130 PRESTON EXECUTIVE DR STE 204
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City | CARY
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State | NC
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Zip | 27513-8433
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Country | US
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Telephone | 919-388-9103
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Fax | 919-388-9701
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Provider Business Mailing Address
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Address Line | 130 PRESTON EXECUTIVE DR STE 204
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City | CARY
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State | NC
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Zip | 27513-8433
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Country | US
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Telephone | 919-388-9103
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Fax | 919-388-9701
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Authorized Official
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Title or Position | OWNER OPERATOR
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Name | DR. SHEEL DESAI SOLOMON
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Credential |
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Telephone | 919-448-5145
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 200001403404
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License Number State | NC
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