NEWPORT DERMATOLOGY PLLC NPI 1093063216

NPI Information

  • NPI: 1093063216
  • Provider Name: NEWPORT DERMATOLOGY PLLC
  • Classification: Clinic/Center - 261Q00000X
  • Entity Type: Organization
  • Former Legal Business Name: NEWPORT DERMATOLOGY
  • Address: 285 HOWARD BLVD
    NEWPORT, NC
    ZIP 28570
  • Phone: (252) 223-3405

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NPI Details

NEWPORT DERMATOLOGY PLLC is a clinic center in Newport, NC. The provider is a facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). NEWPORT DERMATOLOGY PLLC NPI is 1093063216. The provider is registered as an organization entity type.
The provider Former Legal Business Name Is Newport Dermatology.

The provider's business location address is:

285 HOWARD BLVD
NEWPORT, NC
ZIP 28570-927
Phone: (252) 223-3405
Fax: (252) 223-4216

The provider's authorized official is Maurice Dana .
The authorized official title is Sole Member and has the following contact phone number (252) 223-4054.

The enumeration date for this NPI number is 8/20/2012 and was last updated on 10/30/2013.

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
1261Q00000XClinic/Center30120NORTH 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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1C83446MEDICARE UPIN
28926870MEDICAIDNORTH CAROLINA
3C355MEDICARE PINNORTH 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: 11/21/2025

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