Organization
DERMATOLOGY CENTER FOR SKIN HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BARBARA HAWTHORNE (PRACTICE ADMINISTRATOR)
(304) 225-2236
Entity
Organization
Contact information
Practice address
600 SUNCREST TOWN CENTRE DR STE 115, MORGANTOWN, WV 26505-1873
(304) 598-3888
(304) 598-0564
Mailing address
600 SUNCREST TOWN CENTRE DR STE 115, MORGANTOWN, WV 26505-1873
(304) 598-3888
(304) 598-0564
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
21247
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001722467
BLUE CROSS
WV
05
—
3810002533
—
WV
01
—
WV21247A
HEALTH PLAN
WV
Enumeration date
05/14/2007
Last updated
11/06/2019
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