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General NPI Number Information
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NPI Number | 1740746429
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Entity Type | Organization
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Legal Business Name | PERRY DERMATOLOGY AND DERMATOPATHOLOGY
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Dates
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Enumeration Date | 02/18/2019
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Last Update Date | 08/03/2020
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Provider Practice Location Address
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Address Line | 48 FOLLY ROAD BLVD
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City | CHARLESTON
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State | SC
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Zip | 29407-7507
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Country | US
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Telephone | 843-769-2100
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Fax |
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Provider Business Mailing Address
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Address Line | 48 FOLLY ROAD BLVD
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City | CHARLESTON
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State | SC
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Zip | 29407-7507
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Country | US
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Telephone | 843-769-2100
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. DAVID MARK PERRY
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Credential | MD
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Telephone | 843-697-6649
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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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