Forefront Dermatology, S.C.
Dermatology in St Simons Island, GA. Organization (NPI-2).
NPI number1154938579
StatusActive
Last updated in NPPESNov 19, 2020
Details
- NPI
- 1154938579
- Entity type
- Organization (NPI-2)
- Legal business name
- Forefront Dermatology, S.C.
- Organization subpart
- No
- Enumeration date
- Sep 29, 2020
- Certification date
- Nov 19, 2020
- Last updated
- Nov 19, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207N00000X | Dermatology | – | – | Yes |
| 207ND0101X | Dermatology, MOHS-Micrographic Surgery | – | – | |
| 207NS0135X | Dermatology, Procedural Dermatology | – | – | |
| 207X00000X | Orthopaedic Surgery | – | – |
Other names
- Atlantic Shore Dermatology, A Forefront Dermatology Practice (Doing Business As)
Practice location
7000 Wellness Way Ste 7120St Simons Island, GA 31522-2286
Phone 912-634-4966 · Fax 912-634-6542
Mailing address
801 York StManitowoc, WI 54220-4630
Phone 920-663-9008 · Fax 920-684-1439
Other practice locations
2804 Saint Marys Rd
Saint Marys, GA 31558-4559
Saint Marys, GA 31558-4559
Phone 912-439-3186 · Fax 912-634-6542
400 Lister St
Waycross, GA 31501-5226
Waycross, GA 31501-5226
Phone 912-283-4850 · Fax 912-283-4864
Authorized official
Betsy J Wernli
President
9204820671
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