MEDICARE: MAJURE SKIN CARE & WELLNESS 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
1	207Q00000X	Family Medicine Physician	200101087	NC

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	DS1904	OTHER	NC	RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	8276614	OTHER		CIGNA
4	021VN	OTHER	NC	BCBS
5	1290H	OTHER	NC	BCBS

General Provider Information

NPI Number	:	1871768507
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MAJURE SKIN CARE & WELLNESS CENTER, PA

Provider Business Mailing Address
First Line	:	348 N SOUTH ST
Second Line	:
City	:	MOUNT AIRY
State	:	NC
Zip	:	27030-3532
Country	:	US
Telephone Number	:	336-786-6945
Fax Number	:	336-789-5782

Provider Business Practice Location Address
First Line	:	348 N SOUTH ST
Second Line	:
City	:	MOUNT AIRY
State	:	NC
Zip	:	27030-3532
Country	:	US
Telephone Number	:	336-786-6945
Fax Number	:	336-789-5782

Authorized Official
Title or Position	:	OWNER
Name	:	MR. DAVID A MAJURE
Credential	:	MD
Telephone Number	:	336-786-6945

Provider Enumeration Date	:	04/24/2008
Last Update Date	:	07/30/2013

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Directions to “MAJURE SKIN CARE & WELLNESS CENTER, PA ” Practice Location

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