Fora Dermatology PLLC
Dermatology, MOHS-Micrographic Surgery in Mooresville, NC. Organization (NPI-2).
NPI number1366086597
StatusActive
Last updated in NPPESJun 4, 2023
Details
- NPI
- 1366086597
- Entity type
- Organization (NPI-2)
- Legal business name
- Fora Dermatology PLLC
- Organization subpart
- No
- Enumeration date
- Oct 31, 2019
- Certification date
- Jun 4, 2023
- Last updated
- Jun 4, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207ND0101X | Dermatology, MOHS-Micrographic Surgery | – | – | Yes |
| 207N00000X | Dermatology | – | – | |
| 207NS0135X | Dermatology, Procedural Dermatology | – | – |
Other names
- PC Dermatology PLLC (Former Legal Business Name)
Practice location
118 Gateway Blvd Ste AMooresville, NC 28117-6542
Phone 704-230-1302 · Fax 704-230-1284
Mailing address
118 Gateway Blvd Ste AMooresville, NC 28117-6542
Phone 704-230-1302 · Fax 704-230-1284
Other practice locations
128 Medical Park Rd Ste 201
Mooresville, NC 28117-8579
Mooresville, NC 28117-8579
Phone 704-230-1302 · Fax 704-230-1284
Authorized official
Bishr Al Dabagh
Owner
7042301302
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
Other MOHS-Micrographic Surgery Physician providers in Mooresville, NC
Checking a whole list?
Paste up to 5,000 NPIs and download status, name, taxonomy, license and address for each one. Useful for credentialing, billing and pharmacy claim checks.