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CAROLINA DERMATOLOGY CLINIC PA NPI 1639202294


NPI Information

NPI: 1639202294
Provider Name: CAROLINA DERMATOLOGY CLINIC, PA
Classification: Dermatology - 207N00000X
Entity Type: Organization
Address:
933 SAINT ANDREWS BLVD
CHARLESTON, SC
ZIP 29407
Phone: (843) 766-9868
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CAROLINA DERMATOLOGY CLINIC, PA is a dermatology in Charleston, SC. The provider is a dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. CAROLINA DERMATOLOGY CLINIC, PA NPI is 1639202294. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

933 SAINT ANDREWS BLVD
CHARLESTON, SC
ZIP 29407
Phone: (843) 766-9868
Fax: (843) 571-4925

The provider's authorized official is Edward A. Kotz .
The authorized official title is Owner and has the following contact phone number (843) 766-9868.

The enumeration date for this NPI number is 3/13/2007 and was last updated on 1/18/2011.


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
1174400000XSpecialist24039SOUTH CAROLINANo
2207N00000XDermatology24039SOUTH 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
1I24579MEDICARE UPINSOUTH CAROLINA
2240395MEDICAIDSOUTH CAROLINA
3GROUPGP4945MEDICAIDSOUTH CAROLINA
4AA07608162MEDICARE 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: 4/28/2024

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