Organization
EASTERM DERMATOLOGY, PA
Active
Parent organization
EASTERN DERMATOLOGY, PA
Organization subpart
Yes
Provider details
NPI number
Legal business name
EASTERN DERMATOLOGY, PA
Authorized official
DR. CAMERON L SMITH MD (PARTNER)
(252) 752-4124
Entity
Organization
Contact information
Practice address
420 SPRING FOREST RD, GREENVILLE, NC 27834-7244
(252) 752-4124
(252) 758-8954
Mailing address
1165 CEDAR POINT BLVD, SUIE F, CEDAR POINT, NC 28584-8023
(252) 764-2986
(252) 758-8954
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
NC
207ND0101X
MOHS-Micrographic Surgery Physician
—
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01498
BCBS
NC
05
—
8901498
—
NC
Enumeration date
10/08/2015
Last updated
10/08/2015
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