MEDICARE: ALAMANCE DERMATOLOGY, P.A.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	00-21365	NC

General Provider Information

NPI Number	:	1134308174
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALAMANCE DERMATOLOGY, P.A.

Provider Business Mailing Address
First Line	:	1638 MEMORIAL DR
Second Line	:
City	:	BURLINGTON
State	:	NC
Zip	:	27215-3518
Country	:	US
Telephone Number	:	336-226-8000
Fax Number	:	336-228-7585

Provider Business Practice Location Address
First Line	:	1638 MEMORIAL DR
Second Line	:
City	:	BURLINGTON
State	:	NC
Zip	:	27215-3518
Country	:	US
Telephone Number	:	336-226-8000
Fax Number	:	336-228-7585

Authorized Official
Title or Position	:	PRESIDENT
Name	:	JAMES B PATTERSON
Credential	:	M.D., PH.D.
Telephone Number	:	336-226-8000

Provider Enumeration Date	:	10/26/2007
Last Update Date	:	10/26/2007

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