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Organization

DERMATOLOGY ASSOCIATES OF THE LOWCOUNTRY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DOLORES J WADE (ASST. MGR)
(843) 689-5259
Entity
Organization

Contact information

Practice address
108 MEDICAL PARK DR, WALTERBORO, SC 29488-5719
(843) 549-6945
(843) 549-6741
Mailing address
3901 MAIN ST, SUITE D, HILTON HEAD ISLAND, SC 29926-4614
(843) 689-5259
(843) 689-3797

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
207ND0101X
MOHS-Micrographic Surgery Physician
207NS0135X
Procedural Dermatology Physician

Other

Enumeration date
07/03/2006
Last updated
03/14/2008
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