Organization
DERMATOLOGY LASER AND VEIN SPECIALISTS OF THE CAROLINA'S, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GIRISH S MUNAVALLI M.D (MEDICAL DIRECTOR)
(704) 375-6766
Entity
Organization
Contact information
Practice address
1918 RANDOLPH RD, SUITE 550, CHARLOTTE, NC 28207-1100
(704) 375-6766
Mailing address
1918 RANDOLPH RD, SUITE 550, CHARLOTTE, NC 28207-1100
(704) 375-6766
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
207ND0101X
MOHS-Micrographic Surgery Physician
—
—
Other
Enumeration date
10/05/2006
Last updated
12/26/2007
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