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CAROLINA DERMATOLOGY GRP NPI 1083693857


NPI Information

NPI: 1083693857
Provider Name: CAROLINA DERMATOLOGY GRP
Classification: Dermatology - 207N00000X
Entity Type: Organization
Address:
1706 ST JULIANS PLACE
COLUMBIA, SC
ZIP 29204
Phone: (803) 771-7506
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CAROLINA DERMATOLOGY GRP is a dermatology in Columbia, 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 GRP NPI is 1083693857. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

1706 ST JULIANS PLACE
COLUMBIA, SC
ZIP 29204-410
Phone: (803) 771-7506
Fax: (803) 771-9455

The provider's authorized official is Mark G Blaskis .
The authorized official title is President and has the following contact phone number (803) 771-7506.

The enumeration date for this NPI number is 1/11/2006 and was last updated on 8/30/2011.


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
1207ND0101XDermatologyMOHS-Micrographic SurgerySOUTH CAROLINANo
2207ND0900XDermatologyDermatopathologyNo
3207N00000XDermatologySOUTH 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
1AA08524810MEDICARE UPINSOUTH CAROLINA
2AA70174810MEDICARE UPINSOUTH CAROLINA
3AA13324810MEDICARE UPINSOUTH CAROLINA
4AA52144810MEDICARE UPINSOUTH CAROLINA
5F96824MEDICARE UPINSOUTH CAROLINA
6GP1028MEDICAIDSOUTH CAROLINA
7H57701MEDICARE UPINSOUTH CAROLINA
8H89943MEDICARE UPINSOUTH CAROLINA
9H36795MEDICARE UPINSOUTH CAROLINA
10AA42004810MEDICARE UPINSOUTH CAROLINA
114810MEDICARE 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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