Organization
NORTH CAROLINA CENTER FOR DERMATOLOGY PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEFFREY WELLINGTON SCALES M.D. (PHYSICIAN)
(919) 484-9551
Entity
Organization
Contact information
Practice address
6216 FAYETTEVILLE RD, SUITE 102, DURHAM, NC 27713-6287
(919) 484-9551
(919) 484-0667
Mailing address
6216 FAYETTEVILLE RD, SUITE 102, DURHAM, NC 27713-6287
(919) 484-9551
(919) 484-0667
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
9400629
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
012N1
BLUE CROSS BLUE SHIELD
NC
05
—
5905605
—
NC
Enumeration date
12/19/2006
Last updated
07/08/2014
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