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General NPI Number Information
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NPI Number | 1447597752
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Entity Type | Organization
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Legal Business Name | STEELECREEK DERMATOLOGY PLLC
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Dates
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Enumeration Date | 01/07/2013
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Last Update Date | 09/02/2013
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Provider Practice Location Address
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Address Line | 13557 STEELECROFT PKWY SUITE 2500
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City | CHARLOTTE
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State | NC
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Zip | 28278-7550
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Country | US
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Telephone | 704-587-3200
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Fax | 704-587-0044
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Provider Business Mailing Address
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Address Line | 13557 STEELECROFT PKWY SUITE 2500
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City | CHARLOTTE
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State | NC
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Zip | 28278-7550
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Country | US
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Telephone | 704-587-3200
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Fax | 704-587-0044
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Authorized Official
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Title or Position | PRESIDENT
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Name | JENNIFER L HELTON
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Credential | M.D.
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Telephone | 704-587-3200
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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 | 94-00526
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License Number State | NC
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