Organization
DERMATOLOGIC SURGERY OF THE CAROLINAS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID R LANE MD (OWNER)
(704) 302-3707
Entity
Organization
Contact information
Practice address
15830 BALLANTYNE MEDICAL PLACE, SUITE 225, CHARLOTTE, NC 28277
(704) 919-1105
(704) 910-3163
Mailing address
15830 BALLANTYNE MEDICAL PLACE, SUITE 225, CHARLOTTE, NC 28277
(704) 919-1105
(704) 910-3163
Taxonomy
Speciality
Code
Description
License number
State
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
—
—
Other
Enumeration date
01/10/2008
Last updated
06/02/2014
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