Organization
CAROLINAS SKIN CENTER PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID JOHN NOWICKY M.D. (PRESIDENT)
(980) 254-8405
Entity
Organization
Contact information
Practice address
3315 SPRINGBANK LANE, SUITE 202, CHARLOTTE, NC 28226
(704) 997-7070
(704) 997-7069
Mailing address
3315 SPRINGBANK LANE, SUITE 202, CHARLOTTE, NC 28226
(704) 997-7070
(704) 997-7069
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2010838
MEDICARE PTAN NUMBER
NC
05
—
891317V
—
NC
Enumeration date
10/10/2016
Last updated
11/04/2016
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