Organization
EASTERN DERMATOLOGY PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CAMERON LANGLEY SMITH MD (PRESIDENT)
(252) 752-4124
Entity
Organization
Contact information
Practice address
222 VIRGINIA RD, EDENTON, NC 27932-9667
(252) 482-5661
(252) 758-8954
Mailing address
420 SPRING FOREST RD, GREENVILLE, NC 27834-7244
(252) 752-4124
(252) 758-8954
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01498
BCBS NC
NC
05
—
5902502
—
NC
Enumeration date
05/07/2007
Last updated
10/11/2007
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