| NPI | 1982630125 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOLORES J WADE Asst. Mgr 843-689-5259 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology |
| Additional Taxonomies | 207ND0101X Dermatology MOHS-Micrographic Surgery |
| 207NS0135X Dermatology Procedural Dermatology | |
| Enumeration Date | 2006-06-22 |
| Last Update Date | 2008-03-14 |