Organization
EPIPHANY DERMATOLOGY OF SOUTH CAROLINA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GHEORGHE PUSTA (EXECUTIVE DIRECTOR)
(512) 628-0465
Entity
Organization
Contact information
Practice address
28 MEDICAL RIDGE DR, GREENVILLE, SC 29605-4267
(864) 271-7440
(864) 679-6132
Mailing address
7300 RANCH ROAD 2222, BLDG 1, STE 200, AUSTIN, TX 78730-3255
(512) 628-0465
(512) 233-2711
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
—
—
207N00000X
Dermatology Physician
Primary
—
—
Other
Enumeration date
11/16/2006
Last updated
06/02/2026
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