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Organization

DERMONE PLASTIC SURGERY ASSOCIATES OF NORTH CAROLINA, PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. DEIDRA BLANKS MD (PHYSICIAN)
(910) 840-3093
Entity
Organization

Contact information

Practice address
6752 ROCK SPRING RD, SUITE 200, WILMINGTON, NC 28405-3179
(910) 762-1070
(732) 731-6735
Mailing address
200 BARR HARBOR DRIVE, SUITE 200, FOUR TOWER BRIDGE, WEST CONSHOHOCKEN, PA 19428
(848) 240-2812
(732) 731-6135

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
207N00000X
Dermatology Physician
207ND0101X
MOHS-Micrographic Surgery Physician
208200000X
Plastic Surgery Physician
Primary

Other

Enumeration date
12/14/2015
Last updated
12/14/2015
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