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General NPI Number Information
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NPI Number | 1750490306
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Entity Type | Organization
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Legal Business Name | CAROLINA DERMATOLOGY CENTER
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Dates
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Enumeration Date | 08/29/2006
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Last Update Date | 02/19/2008
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Provider Practice Location Address
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Address Line | 1900 ASHWOOD CT
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City | GREENSBORO
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State | NC
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Zip | 27455-3005
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Country | US
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Telephone | 336-282-1414
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1689
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City | ETOWAH
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State | NC
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Zip | 28729-1689
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | BILLING
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Name | DEBBIE REINELT
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Credential |
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Telephone | 828-891-5524
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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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