Organization
CAROLINA SKIN CARE, PA
Active
Organization
CAROLINA SKIN CARE, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID IVAN KLUMPAR MD (CEO PRESIDENT)
(910) 295-7546
Entity
Organization
Contact information
Practice address
125 FOX HOLLOW RD, STE 210, PINEHURST, NC 28374-8511
(910) 295-7546
(910) 692-2831
Mailing address
125 FOX HOLLOW RD, STE 210, PINEHURST, NC 28374-8511
(910) 295-7546
(910) 692-2831
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
34653
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0153Y
BLUECROSSBLUESHIELD
NC
01
—
1730283276
INDIVIDUAL NPI
NC
05
—
8949708
—
NC
01
—
CE7551
RAILROAD MEDICARE
NC
Enumeration date
12/18/2006
Last updated
03/09/2010
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