Organization
GEORGIA DERMATOLOGY & SKIN CANCER CENTER, LLC
Active
Organization
GEORGIA DERMATOLOGY & SKIN CANCER CENTER, LLC
Active
Other names
Georgia Dermatology & Skin Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL J SHARKEY MD (OWNER)
(478) 275-2694
Entity
Organization
Contact information
Practice address
2400 BELLEVUE RD, 16 ERIN OFFICE PARK, DUBLIN, GA 31021-2885
(478) 328-0281
(478) 328-0438
Mailing address
2400 BELLEVUE RD STE 21A, DUBLIN, GA 31021-2890
(478) 328-0281
(478) 328-0438
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
207ND0101X
MOHS-Micrographic Surgery Physician
—
—
207ND0900X
Dermatopathology Physician
—
—
207NI0002X
Clinical & Laboratory Dermatological Immunology Physician
—
—
207NP0225X
Pediatric Dermatology Physician
—
—
207NS0135X
Procedural Dermatology Physician
—
—
207ZD0900X
Dermatopathology (Pathology) Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DC4061
RAILROAD MEDICARE
GA
Enumeration date
05/05/2006
Last updated
10/30/2007
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