Provider Type Icon

DERMATOLOGIC SURGERY OF THE CAROLINAS LLC NPI 1790961670


NPI Information

NPI: 1790961670
Provider Name: DERMATOLOGIC SURGERY OF THE CAROLINAS LLC
Classification: Dermatology - 207ND0101X
Entity Type: Organization

Specialization: MOHS-Micrographic Surgery

CLIA Number: 34D2002253

Address:
15830 BALLANTYNE MEDICAL PLACE
SUITE 225
CHARLOTTE, NC
ZIP 28277
Phone: (704) 919-1105
Get Directions

DERMATOLOGIC SURGERY OF THE CAROLINAS LLC is a mohs-micrographic surgery dermatology in Charlotte, 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. DERMATOLOGIC SURGERY OF THE CAROLINAS LLC NPI is 1790961670. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

15830 BALLANTYNE MEDICAL PLACE
SUITE 225
CHARLOTTE, NC
ZIP 28277
Phone: (704) 919-1105
Fax: (704) 910-3163

The provider's authorized official is David R Lane .
The authorized official title is Owner and has the following contact phone number (704) 302-3707.

The CLIA number assigned to this NPI record is 34D2002253 - physician office with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 1/10/2008 and was last updated on 6/2/2014.


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 SurgeryYes

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
12075624MEDICARE 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: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.