Organization
RALEIGH SKIN SURGERY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TAMARA S HOUSMAN MD (MEDICAL DIRECTOR)
(919) 390-0210
Entity
Organization
Contact information
Practice address
3811 ED DR., 110, RALEIGH, NC 27612-8106
(919) 390-0200
(919) 390-0219
Mailing address
3811 ED DRIVE, SUITE 110, RALEIGH, NC 27612-8106
(919) 390-0200
(919) 390-0219
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
—
—
207ND0101X
MOHS-Micrographic Surgery Physician
200001428
NC
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2021987A
MEDICARE PTAN
—
Enumeration date
03/11/2008
Last updated
08/21/2025
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