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
Update your record
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