Organization
EASTERN DERMATOLOGY, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CAMERON LANGLEY SMITH M.D. (PRESIDENT)
(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
420 SPRING FOREST RD, GREENVILLE, NC 27834-7244
(252) 752-4124
(252) 758-8954
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
207ND0101X
MOHS-Micrographic Surgery Physician
—
—
207ND0900X
Dermatopathology Physician
—
—
207NP0225X
Pediatric Dermatology Physician
—
—
207NS0135X
Procedural Dermatology Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01498
BCBS OF NC GROUP
NC
05
—
5922478
—
NC
Enumeration date
09/07/2005
Last updated
05/20/2013
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