Organization
ISLAND PARK DERMATOLOGY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CYNTHIA IRBY WILSON MD (OWNER)
(843) 469-5641
Entity
Organization
Contact information
Practice address
109 RIVER LANDING DR STE 400, DANIEL ISLAND, SC 29492-7300
(843) 469-5641
Mailing address
109 RIVER LANDING DR STE 400, DANIEL ISLAND, SC 29492-7300
(843) 469-5641
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Enumeration date
12/12/2022
Last updated
12/12/2022
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