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SOUTH CAROLINA SKIN CANCER CENTER NPI 1154344547


NPI Information

NPI: 1154344547
Provider Name: SOUTH CAROLINA SKIN CANCER CENTER
Classification: Dermatology - 207ND0101X
Entity Type: Organization

Specialization: MOHS-Micrographic Surgery

CLIA Number: 42D1059762

Address:
300 ASHBY PARK LANE
GREENVILLE, SC
ZIP 29607
Phone: (864) 288-1154
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SOUTH CAROLINA SKIN CANCER CENTER is a mohs-micrographic surgery dermatology in Greenville, SC. The provider is the highly-trained surgeons that perform Mohs Micrographic Surgery are specialists both in dermatology and pathology. With their extensive knowledge of the skin and unique pathological skills, they are able to remove only diseased tissue, preserving healthy tissue and minimizing the cosmetic impact of the surgery. Mohs surgeons who belong to the American College of Mohs Surgery (ACMS) have completed a minimum of one year of fellowship training at one of the ACMS-approved training centers in the U.S. SOUTH CAROLINA SKIN CANCER CENTER NPI is 1154344547. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

300 ASHBY PARK LANE
GREENVILLE, SC
ZIP 29607-903
Phone: (864) 288-1154
Fax: (864) 288-2554

The provider's authorized official is James R Debloom .
The authorized official title is Owner/physician and has the following contact phone number (864) 288-1154.

The CLIA number assigned to this NPI record is 42D1059762 - physician office with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 7/26/2006 and was last updated on 10/16/2007.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207ND0101XDermatologyMOHS-Micrographic SurgeryTL28759SOUTH CAROLINAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
18573MEDICARE PINSOUTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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