Organization
SOUTHSIDE DERMATOLOGY
Active
Other names
MedSouth Specialties, PC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KATHERINE RENEE HAMLET M.D. (OWNER)
(803) 644-0100
Entity
Organization
Contact information
Practice address
521 SILVER BLUFF RD, AIKEN, SC 29803-6011
(803) 644-0100
(803) 644-0110
Mailing address
521 SILVER BLUFF RD, AIKEN, SC 29803-6011
(803) 644-0100
(803) 644-0110
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
19769
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5082199
AETNA
—
01
—
CF9971
MEDICARE RAILROAD
SC
Enumeration date
02/14/2008
Last updated
04/20/2008
Update your record
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