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General NPI Number Information
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NPI Number | 1669494621
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Entity Type | Organization
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Legal Business Name | DIGITAL DERM, INC
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Dates
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Enumeration Date | 07/25/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1334 SUMTER ST
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City | COLUMBIA
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State | SC
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Zip | 29201-3324
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Country | US
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Telephone | 803-454-1295
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Fax | 803-978-7456
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Provider Business Mailing Address
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Address Line | 1334 SUMTER ST
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City | COLUMBIA
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State | SC
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Zip | 29201-3324
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Country | US
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Telephone | 803-454-1295
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Fax | 803-978-7456
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Authorized Official
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Title or Position | CEO
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Name | MARTIN LEFKOWITZ
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Credential |
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Telephone | 803-454-1295
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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 |
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License Number State |
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