FORA DERMATOLOGY PLLC NPI 1366086597

NPI Information

  • NPI: 1366086597
  • Provider Name: FORA DERMATOLOGY PLLC
  • Classification: Dermatology - 207ND0101X
  • Specialization: MOHS-Micrographic Surgery
  • Entity Type: Organization
  • Former Legal Business Name: PC DERMATOLOGY PLLC
  • CLIA Number: 34D2321019
  • Address: 118 GATEWAY BLVD STE A
    MOORESVILLE, NC
    ZIP 28117
  • Phone: (704) 230-1302

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NPI Details

FORA DERMATOLOGY PLLC is a mohs-micrographic surgery dermatology in Mooresville, NC. 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. FORA DERMATOLOGY PLLC NPI is 1366086597. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Former Legal Business Name Is Pc Dermatology Pllc.

The provider's business location address is:

118 GATEWAY BLVD STE A
MOORESVILLE, NC
ZIP 28117-542
Phone: (704) 230-1302
Fax: (704) 230-1284

The provider's authorized official is Bishr Al Dabagh .
The authorized official title is Owner and has the following contact phone number (704) 230-1302.

The CLIA number assigned to this NPI record is 34D2321019 - physician office with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 10/31/2019 and was last updated on 6/4/2023.

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
1207N00000XDermatologyNo
2207NS0135XDermatologyProcedural DermatologyNo
3207ND0101XDermatologyMOHS-Micrographic SurgeryYes

What is NPI?

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This page was last updated on: 11/21/2025

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