Organization
MT PLEASANT DERMATOLOGY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TONYA M ROPER (CREDENTIALING MANAGER)
(843) 936-7189
Entity
Organization
Contact information
Practice address
570 LONG POINT ROAD, SUITE 200, MT. PLEASANT, SC 29464
(843) 881-0320
(843) 881-5453
Mailing address
570 LONG POINT ROAD, SUITE 200, MT. PLEASANT, SC 29464
(843) 881-0320
(843) 881-5453
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
—
SC
207N00000X
Dermatology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP0213
—
SC
Enumeration date
05/11/2006
Last updated
08/12/2025
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