Organization
RAVENHILL DERMATOLOGY MEDICAL CLINIC, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEBBIE REINELT (BILLING)
(828) 891-5524
Entity
Organization
Contact information
Practice address
110 BARCELONA DR, FAYETTEVILLE, NC 28303-4453
(910) 485-4101
Mailing address
110 BARCELONA DR, FAYETTEVILLE, NC 28303-4453
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
83124
BLUE CROSS BLUE SHIELD
—
05
—
8983124
—
NC
Enumeration date
08/23/2006
Last updated
06/16/2008
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