Organization
CAPITAL DERMATOLOGY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JULIE JEFFERSON MD (OWNER AND PHYSICIAN)
(803) 603-5923
Entity
Organization
Contact information
Practice address
610 COLUMBIANA DR, COLUMBIA, SC 29212-0728
(803) 603-5923
Mailing address
7001 SAINT ANDREWS RD STE A12 #243, COLUMBIA, SC 29212-1137
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
—
—
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
—
—
207NS0135X
Procedural Dermatology Physician
—
—
Other
Enumeration date
04/21/2023
Last updated
04/21/2023
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