Organization
MEDICAL & SURGICAL DERMATOLOGY, LLC
Active
Organization
MEDICAL & SURGICAL DERMATOLOGY, LLC
Active
Other names
Westgate Dermatology
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PETER J NEIDENBACH M.D. (PHYSICIAN)
(828) 894-2473
Entity
Organization
Contact information
Practice address
55 PALMER JERVEY DR STE B, COLUMBUS, NC 28722-0580
(828) 894-2473
(828) 894-2390
Mailing address
52 HOSPITAL DR STE 3A, COLUMBUS, NC 28722-8516
(828) 894-2473
(828) 894-2390
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
66555
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2336482
MEDICARE PTAN
NC
01
—
9501356
MEDICAL LICENSE
NC
01
—
MMM.16384MD
MEDICAL LICENSE
SC
Enumeration date
04/20/2007
Last updated
07/10/2025
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