Organization
SOUTH COAST DERMATOLOGY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERESA DEGIACOMO MD (MEDICAL DOCTOR)
(781) 335-9700
Entity
Organization
Contact information
Practice address
90 LIBBEY PKWY, SUITE 200, WEYMOUTH, MA 02189-3100
(781) 335-9700
(781) 335-9709
Mailing address
90 LIBBEY PKWY, SUITE 200, WEYMOUTH, MA 02189-3100
(781) 335-9700
(781) 335-9709
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
691531
TUFTS
—
05
—
9713361
—
MA
01
—
M17965
BC/BS
—
Enumeration date
12/02/2005
Last updated
02/22/2018
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