Organization
NORTHEAST DERMATOLOGY, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LEE SMITH CARSON M.D. (PRESIDENT)
(803) 736-4560
Entity
Organization
Contact information
Practice address
220 GRACES WAY, COLUMBIA, SC 29229
(803) 736-4560
(803) 744-1217
Mailing address
220 GRACES WAY, COLUMBIA, SC 29229
(803) 736-4560
(803) 744-1217
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
22975
SC
Other
Enumeration date
09/26/2006
Last updated
03/07/2023
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