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Organization

EASTERN DERMATOLOGY & PATHOLOGY, PA

Active
Parent organization
EASTERN DERMATOLOGY & PATHOLOGY, PA
Organization subpart
Yes

Provider details

NPI number
Legal business name
EASTERN DERMATOLOGY & PATHOLOGY, PA
Authorized official
DR. CAMERON LANGLEY SMITH MD (PRESIDENT)
(252) 752-4124
Entity
Organization

Contact information

Practice address
1314 HIGHLAND DR, WASHINGTON, NC 27889-3424
(252) 752-4124
(252) 752-6106
Mailing address
420 SPRING FOREST RD, GREENVILLE, NC 27834-7244
(252) 752-4124
(252) 752-6106

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
01498
BCBSNC
NC
01
230298
MEDICARE
NC
05
8901498
NC
Enumeration date
01/18/2010
Last updated
08/22/2011
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