Organization
FOOTHILLS FAMILY DERMATOLOGY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KIM D EDHEGARD II MD (DERMATOLOGIST)
(828) 475-2646
Entity
Organization
Contact information
Practice address
109 E FLEMING DR STE 106, MORGANTON, NC 28655-3799
(828) 475-2646
Mailing address
PO BOX 3583, MORGANTON, NC 28680
(828) 475-2646
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1164657391
—
NC
05
—
1487855680
—
NC
Enumeration date
11/04/2020
Last updated
04/12/2021
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