| NPI | 1083693857 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK G BLASKIS President 803-771-7506 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology |
| Additional Taxonomies | 207ND0101X Dermatology, MOHS-Micrographic Surgery |
| 207ND0900X Dermatology, Dermatopathology | |
| Enumeration Date | 2006-01-11 |
| Last Update Date | 2011-08-30 |