Organization
HILTON HEAD DERMATOLOGY AND SKIN CANCER CENTER PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALBERT THOMAS BUNDY M.D. (PRESIDENT)
(843) 689-9200
Entity
Organization
Contact information
Practice address
15 HOSPITAL CENTER BLVD STE 1, HILTON HEAD, SC 29926-2760
(843) 689-9200
(843) 689-9201
Mailing address
15 HOSPITAL CENTER BLVD STE 1, HILTON HEAD, SC 29926-2760
(843) 689-9200
(843) 689-9201
Taxonomy
Speciality
Code
Description
License number
State
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
SC14710
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP1264
—
SC
Enumeration date
10/26/2006
Last updated
07/08/2015
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