Organization
WAYNE DERMATOLOGY AND COSMETIC SURGERY PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN HAVERKAMP MD (OWNER)
(919) 734-0944
Entity
Organization
Contact information
Practice address
1100 E ASH STREET, GOLDSBORO, NC 27530-5102
(919) 734-0944
(919) 734-1921
Mailing address
PO BOX 1399, 1100 E ASH STREET, GOLDSBORO, NC 27533-1399
(919) 734-0944
(919) 734-1921
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
24161
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8902920
—
NC
Enumeration date
08/03/2006
Last updated
03/22/2012
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