Organization
WESTSIDE DERMATOLOGY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PETER J NEIDENBACH M.D. (MEMBER)
(864) 574-0017
Entity
Organization
Contact information
Practice address
1410B JOHN B WHITE SR BLVD, SPARTANBURG, SC 29306-3927
(864) 574-0017
(864) 574-6088
Mailing address
1410B JOHN B WHITE SR BLVD, SPARTANBURG, SC 29306-3927
(864) 574-0017
(864) 574-6088
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
16384
SC
Other
Enumeration date
04/20/2007
Last updated
10/11/2007
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