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1447911938
ADVANCED DERMATOLOGY OF SC PC
FORT MILL, SC
NPI
1447911938
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Entity Type
Organization
Authorized Contact
AMY DECLUE
Director Provider Enrollment
407-917-7293
Organization Subpart ?
Yes
Primary Taxonomy
207N00000X Dermatology
Enumeration Date
2022-01-06
Last Update Date
2022-01-06
Business Address
ADVANCED DERMATOLOGY OF SC PC
1700 FIRST BAXTER XING STE 101
FORT MILL, SC 29708-8950
Phone number: 803-802-3376
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Mailing Address
ADVANCED DERMATOLOGY OF SC PC
151 SOUTHHALL LN STE 300
MAITLAND, FL 32751-7172
Phone number: 079-177-2934
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