Carolina Dermatology, LLC
Dermatology in Charlotte, NC. Organization (NPI-2).
NPI number1144282930
StatusActive
Last updated in NPPESMay 1, 2008
Details
- NPI
- 1144282930
- Entity type
- Organization (NPI-2)
- Legal business name
- Carolina Dermatology, LLC
- Organization subpart
- No
- Enumeration date
- Apr 5, 2006
- Last updated
- May 1, 2008
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207N00000X | Dermatology | – | – | Yes |
Practice location
10502 Park RdSuite 100
Charlotte, NC 28210-8479
Phone 704-542-1366 · Fax 704-542-1063
Mailing address
10502 Park RdSuite 100
Charlotte, NC 28210-8479
Phone 704-542-1366 · Fax 704-542-1063
Authorized official
Gerald Earl Cooley
President/Owner
7045421366
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