Organization
SOUTHERN DERMATOLOGY, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANGELA RUTH PETERMAN (MD)
(443) 351-3376
Entity
Organization
Contact information
Practice address
4201 LAKE BOONE TRL, SUITE 200, RALEIGH, NC 27607-7511
(919) 782-2152
(919) 782-7929
Mailing address
1306 CONCOURSE DR STE 201, LINTHICUM HEIGHTS, MD 21090-1033
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
9900389
NC
Other
Enumeration date
05/19/2006
Last updated
02/14/2025
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