Organization
JAN MCDONALD, M.D.
Active
Other names
McDONALD DERMATOLOGY
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAN A MCDONALD M.D. (PHYSICIAN)
(252) 331-5869
Entity
Organization
Contact information
Practice address
1134 N ROAD ST, STE 2, ELIZABETH CITY, NC 27909-3365
(252) 331-5869
(252) 331-5906
Mailing address
1134 N ROAD ST, STE 2, ELIZABETH CITY, NC 27909-3365
(252) 331-5869
(252) 331-5906
Taxonomy
Speciality
Code
Description
License number
State
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1302X
BCBS
NC
01
—
34D1040854
CLIA
NC
05
—
891302X
—
NC
Enumeration date
11/08/2007
Last updated
06/25/2008
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