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General NPI Number Information
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NPI Number | 1588173447
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Entity Type | Organization
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Legal Business Name | CAPITAL DERMATOLOGY OF NC, PLLC
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Dates
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Enumeration Date | 09/23/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 7209 CREEDMOOR RD STE 105
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City | RALEIGH
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State | NC
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Zip | 27613-1695
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Country | US
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Telephone | 919-307-9461
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Fax |
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Provider Business Mailing Address
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Address Line | 7209 CREEDMOOR RD STE 105
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City | RALEIGH
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State | NC
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Zip | 27613-1695
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Country | US
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Telephone | 919-307-9461
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Fax |
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | MR. MICHAEL R STEELE
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Credential |
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Telephone | 919-809-9001
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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 | 65395
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License Number State | NC
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