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NPI Code Detail

MEDICARE: ADVANCED DERMATOLOGY CENTER, PA

MEDICARE: ADVANCED DERMATOLOGY CENTER, PA
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
1207N00000XDermatology Physician200000825NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1015UGOTHERNCBCBS

General Provider Information

NPI Number : 1487641429
Entity Type Code : Organization
Provider Name (Legal Business Name) : ADVANCED DERMATOLOGY CENTER, PA
Provider Business Mailing Address
First Line : 9604 HOLLY POINT DR
Second Line :
City : HUNTERSVILLE
State : NC
Zip : 28078-4913
Country : US
Telephone Number : 704-895-6775
Fax Number : 704-895-6765
Provider Business Practice Location Address
First Line : 9604 HOLLY POINT DR
Second Line :
City : HUNTERSVILLE
State : NC
Zip : 28078-4913
Country : US
Telephone Number : 704-895-6775
Fax Number : 704-895-6765
Authorized Official
Title or Position : OWNER
Name : DR. STANLEY D HOFFMAN
Credential : M.D
Telephone Number : 704-895-6775
Provider Enumeration Date : 10/04/2005
Last Update Date : 05/20/2008

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Directions to “ADVANCED DERMATOLOGY CENTER, PA ” Practice Location

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