Organization
ANDERSON DERMATOLOGY AND SKIN SURGERY CENTER
Active
Parent organization
ANDERSON DERMATOLOGY AND SKIN SURGERY CENTER, LLC
Other names
Anderson Dermatology and Skin Surgery Center, LLC (Easley)
Organization subpart
Yes
Provider details
NPI number
Legal business name
ANDERSON DERMATOLOGY AND SKIN SURGERY CENTER, LLC
Authorized official
CRYSTAL GREER (CREDENTIALING SPECIALIST)
(864) 716-0063
Entity
Organization
Contact information
Practice address
112 JOHN ST STE 105, EASLEY, SC 29640-1405
(864) 855-2052
(864) 855-2518
Mailing address
1501 N MAIN ST, ANDERSON, SC 29621-4734
(864) 716-0063
(864) 716-0073
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP3575
—
SC
Enumeration date
05/06/2019
Last updated
05/06/2019
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