Organization
MECKLENBURG DERMATOLOGY ASSOCIATES PA
Active
Parent organization
MECKLENBURG DERMATOLOGY ASSOCIATES
Organization subpart
Yes
Provider details
NPI number
Legal business name
MECKLENBURG DERMATOLOGY ASSOCIATES
Authorized official
MS. VANESSA FLEMING (MANAGER)
(704) 344-8846
Entity
Organization
Contact information
Practice address
811 COX RD, GASTONIA, NC 28054-3453
(704) 833-0077
(704) 865-7584
Mailing address
811 COX RD, GASTONIA, NC 28054-3453
(704) 833-0077
(704) 865-7584
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
88363
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
89011AX
—
NC
Enumeration date
05/14/2008
Last updated
05/14/2008
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