POLLEY CLINIC OF DERMATOLOGY & DERMATOLOGIC SURGERY NPI 1104847714

NPI Information

NPI: 1104847714
Provider Name: POLLEY CLINIC OF DERMATOLOGY & DERMATOLOGIC SURGERY
Classification: Dermatology - 207ND0900X
Entity Type: Organization

Specialization: Dermatopathology

CLIA Number: 34D2098517

Address:
1806 GLENDALE DR SW
WILSON, NC
ZIP 27893
Phone: (252) 243-0566
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POLLEY CLINIC OF DERMATOLOGY & DERMATOLOGIC SURGERY is a dermatopathology dermatology in Wilson, NC. The provider is a dermatopathologist has the expertise to diagnose and monitor diseases of the skin including infectious, immunologic, degenerative and neoplastic diseases. This entails the examination and interpretation of specially prepared tissue sections, cellular scrapings and smears of skin lesions by means of routine and special (electron and fluorescent) microscopes. POLLEY CLINIC OF DERMATOLOGY & DERMATOLOGIC SURGERY NPI is 1104847714. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1806 GLENDALE DR SW
WILSON, NC
ZIP 27893-402
Phone: (252) 243-0566
Fax: (252) 243-1347

The provider's authorized official is Kelli Newman .
The authorized official title is Credentialing Specialist and has the following contact phone number (252) 668-7026.

The CLIA number assigned to this NPI record is 34D2098517 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/21/2006 and was last updated on 8/4/2021.

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
1	207ND0900X	Dermatology	Dermatopathology	27881	NORTH CAROLINA	Yes

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
1	0296G	OTHER	NORTH CAROLINA	BCBS OF NC
2	99494	OTHER	NORTH CAROLINA	MEDCOST
3	2222414	OTHER	NORTH CAROLINA	FIRST HEALTH
4	7257619	OTHER	NORTH CAROLINA	AETNA
5	68327	OTHER	NORTH CAROLINA	ACCORDIA
6	DE4848	OTHER	NORTH CAROLINA	RAIL ROAD MEDICARE
7	7068303	OTHER	NORTH CAROLINA	CIGNA
8	785505	OTHER	NORTH CAROLINA	UNITED HEALTH CARE
9	890296G	MEDICAID	NORTH 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

NPI Synchronization or Removal

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