DERMATOLOGY AND SKIN CANCER CENTER OF SOUTH CAROLINA PC NPI 1073946315

NPI Information

  • NPI: 1073946315
  • Provider Name: DERMATOLOGY AND SKIN CANCER CENTER OF SOUTH CAROLINA PC
  • Classification: Dermatology - 207ND0101X
  • Specialization: MOHS-Micrographic Surgery
  • Entity Type: Organization
  • CLIA Number: 42D2074323
  • Address: 5046 HIGHWAY 17 BYP S
    SUITE 103
    MYRTLE BEACH, SC
    ZIP 29588
  • Phone: (843) 668-4104

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NPI Details

DERMATOLOGY AND SKIN CANCER CENTER OF SOUTH CAROLINA PC is a mohs-micrographic surgery dermatology in Myrtle Beach, 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. DERMATOLOGY AND SKIN CANCER CENTER OF SOUTH CAROLINA PC NPI is 1073946315. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

5046 HIGHWAY 17 BYP S
SUITE 103
MYRTLE BEACH, SC
ZIP 29588-503
Phone: (843) 668-4104
Fax: (201) 848-8902

The provider's authorized official is Jospeh M Masessa .
The authorized official title is President and has the following contact phone number (843) 668-4104.

The CLIA number assigned to this NPI record is 42D2074323 - physician office with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 8/9/2013 and was last updated on 10/11/2013.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207N00000XDermatologyMD35615SOUTH CAROLINANo
2207ND0900XDermatologyDermatopathologyMD35615SOUTH CAROLINANo
3207NI0002XDermatologyClinical & Laboratory Dermatological ImmunologyMD35615SOUTH CAROLINANo
4207NS0135XDermatologyProcedural DermatologyMD35615SOUTH CAROLINANo
5207ND0101XDermatologyMOHS-Micrographic SurgeryMD35615SOUTH CAROLINAYes

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This page was last updated on: 3/30/2025

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