Organization
SKIN SURGERY CENTER PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BARRY LESHIN M.D. (PRESIDENT)
(336) 724-2434
Entity
Organization
Contact information
Practice address
1450 PROFESSIONAL PARK DR, SUITE 150, WINSTON SALEM, NC 27103-1300
(336) 724-2434
(336) 724-6123
Mailing address
1450 PROFESSIONAL PARK DR, SUITE 150, WINSTON SALEM, NC 27103-1300
(336) 724-2434
(336) 724-6123
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
011WP
BLUE CROSS BLUE SHIELD OF NORTH CAROLINA
NC
01
—
7110186
AETNA
NC
05
—
89011WP
—
NC
01
—
CH4494
RAILROAD MEDICARE
—
01
—
F309
BLUE MEDICARE
NC
Enumeration date
04/28/2006
Last updated
04/04/2016
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