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Organization

GERMAIN DERMATOLOGY, PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
NELDA FIELDS (CONSULTANT)
(843) 881-4440
Entity
Organization

Contact information

Practice address
612 SEACOAST PKWY, SUITE 201, MOUNT PLEASANT, SC 29464-8247
(843) 881-4440
(843) 884-8540
Mailing address
612 SEACOAST PKWY, SUITE 201, MOUNT PLEASANT, SC 29464-8247
(843) 881-4440
(843) 884-8540

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
22169
SC
207ND0101X
MOHS-Micrographic Surgery Physician
22169
SC
207NS0135X
Procedural Dermatology Physician
22169
SC
363A00000X
Physician Assistant
1048
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1417048638
NPI OF PA
SC
01
1740514223
NPI OF PA
SC
01
1750308219
NPI OF MD
SC
Enumeration date
03/09/2007
Last updated
10/21/2009
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