Organization
FORA DERMATOLOGY PLLC
Active
Other names
PC Dermatology PLLC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BISHR AL DABAGH MD (OWNER)
(704) 230-1302
Entity
Organization
Contact information
Practice address
118 GATEWAY BLVD STE A, MOORESVILLE, NC 28117-6542
(704) 230-1302
(704) 230-1284
Mailing address
118 GATEWAY BLVD STE A, MOORESVILLE, NC 28117-6542
(704) 230-1302
(704) 230-1284
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
—
—
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
—
—
207NS0135X
Procedural Dermatology Physician
—
—
Other
Enumeration date
10/31/2019
Last updated
06/04/2023
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