# DERMATOLOGY ASSOCIATES OF COASTAL CAROLINA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1033459011
- **Authorized official:** DR. JAMES POLO M.D. (MD/OWNER)
- **Authorized official phone:** (252) 633-4461

## Contact information

- **Practice address:** 2145 COUNTRY CLUB RD, JACKSONVILLE, NC 28546-2403
- **Practice address phone:** (252) 633-4461
- **Practice address fax:** (252) 633-6016
- **Mailing address:** PO BOX 890283, CHARLOTTE, NC 28289-0283
- **Mailing address phone:** (252) 633-4461
- **Mailing address fax:** (252) 633-6016

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207NI0002X | Clinical & Laboratory Dermatological Immunology Physician | — | NULL | Yes |
| 207NI0002X | Clinical & Laboratory Dermatological Immunology Physician | — | — | Yes |

## Other

- **Enumeration date:** 02/27/2013
- **Last updated:** 09/21/2022