Organization
DERMATOLOGY ASSOCIATES OF COASTAL CAROLINA, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES M POLO M.D. (MEDICAL DIRECTOR/OWNER)
(252) 633-4461
Entity
Organization
Contact information
Practice address
2115 NEUSE BLVD, NEW BERN, NC 28560-4309
(252) 633-4461
(252) 633-6016
Mailing address
PO BOX 890283, CHARLOTTE, NC 28289-0283
(252) 633-4461
(252) 633-6016
Taxonomy
Speciality
Code
Description
License number
State
207ND0900X
Dermatopathology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
017RM
BCBS GROUP PROVIDER NUMBE
NC
01
—
DF3377
RR MEDICARE
NC
Enumeration date
06/24/2006
Last updated
09/21/2022
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