Organization
DAVIE DERMATOLOGY, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRACIE C BRYSON MD (AUTHORIZED OFFICIAL)
(336) 940-2407
Entity
Organization
Contact information
Practice address
108 DORNACH WAY, ADVANCE, NC 27006-7305
(336) 940-2407
(336) 940-2409
Mailing address
108 DORNACH WAY, ADVANCE, NC 27006-7305
(336) 940-2407
(336) 940-2409
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
890108V
—
NC
Enumeration date
04/06/2006
Last updated
01/16/2023
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