| NPI | 1073946315 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSPEH M MASESSA President 843-668-4104 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207ND0101X Dermatology MOHS-Micrographic Surgery (Licence: SC MD35615) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: SC MD35615) |
| 207ND0900X Dermatology Dermatopathology (Licence: SC MD35615) | |
| 207NI0002X Dermatology Clinical & Laboratory Dermatological Immunology (Licence: SC MD35615) | |
| 207NS0135X Dermatology Procedural Dermatology (Licence: SC MD35615) | |
| Enumeration Date | 2013-08-09 |
| Last Update Date | 2013-10-11 |