Organization
BLUE RIDGE DERMATOLOGY ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LYNDA A AMSDEN (CREDENTIALING COORDINATOR)
(919) 781-1050
Entity
Organization
Contact information
Practice address
4225 MACON POND RD STE 300, RALEIGH, NC 27607-6320
(919) 781-1050
(919) 510-5090
Mailing address
4225 MACON POND RD STE 300, RALEIGH, NC 27607-6320
(919) 781-1050
(919) 510-5090
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8901073
—
NC
Enumeration date
04/05/2006
Last updated
01/07/2025
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