Organization
EASTERN DERMATOLOGY, PA
Active
Organization
EASTERN DERMATOLOGY, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CAMERON LANGLEY SMITH MD (PRESIDENT)
(252) 752-4124
Entity
Organization
Contact information
Practice address
4251 ARENDELL ST, SUITE A, MOREHEAD CITY, NC 28557-2805
(252) 752-4124
(252) 758-8954
Mailing address
420 SPRING FOREST RD, GREENVILLE, NC 27834-7244
(252) 752-4124
(252) 758-8954
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01498
BCBSNC
NC
01
—
230298
MEDICARE GROUP NUMBER
NC
05
—
8901498
—
NC
Enumeration date
05/19/2009
Last updated
08/22/2011
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