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General NPI Number Information
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NPI Number | 1508395468
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Entity Type | Organization
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Legal Business Name | PRESTON DERMATOLOGY & SKIN SURGERY CENTER PA
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Dates
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Enumeration Date | 06/05/2017
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Last Update Date | 10/15/2021
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Provider Practice Location Address
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Address Line | 1010 HIGH HOUSE RD STE 202
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City | CARY
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State | NC
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Zip | 27513-3576
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Country | US
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Telephone | 919-388-9103
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Fax | 919-234-0856
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Provider Business Mailing Address
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Address Line | 1010 HIGH HOUSE RD STE 202
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City | CARY
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State | NC
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Zip | 27513-3576
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Country | US
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Telephone | 919-263-5255
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Fax | 919-435-8405
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Authorized Official
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Title or Position | OWNER/OPERATOR
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Name | SHEEL DESAI SOLOMON
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Credential | MD
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Telephone | 919-388-9103
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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 | 2014-00889
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License Number State | NC
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