Organization
CARY SKIN CENTER, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT E CLARK MD, PHD (PRESIDENT)
(919) 363-7546
Entity
Organization
Contact information
Practice address
200 WELLESLEY TRADE LN, CARY, NC 27519-5576
(919) 363-7546
(919) 363-3616
Mailing address
200 WELLESLEY TRADE LN, CARY, NC 27519-5576
(919) 363-7546
(919) 363-3616
Taxonomy
Speciality
Code
Description
License number
State
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
81706
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01603
BCBS
NC
01
—
30557
WELLPATH
NC
05
—
8901603
—
NC
Enumeration date
04/06/2006
Last updated
04/28/2020
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