DERMATOLOGY AND LASER CENTER OF CHARLESTON/PALMETTO STATE PHARM (NPI# 1508189838) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1508189838 |
Entity Type | Organization |
Organization Name | DERMATOLOGY AND LASER CENTER OF CHARLESTON/PALMETTO STATE PHARM |
Other Organization Name | PRIMARY RX |
Practice Address |
2093 Henry Tecklenburg Dr Suite 300 Charleston SC 29414-5741 |
Mailing Address |
2000 Sam Rittenberg Blvd Suite 3009 Charleston SC 29407-4629 |
Practice Telephone | 8435568886 |
Practice Fax Number | 8883185567 |
Mailing Telephone | 8437697633 |
Mailing Fax Number | 8883185567 |
Enumeration Date | 2010-03-01 |
Last Update Date | 2010-03-03 |
Authorized Official Name | JENNIFER KNAPP (CREDENTIALING SPECIALIST) |
Authorized Official Telephone | 8434084171 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207N00000X | Dermatology | 19977 | SC | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
SC | MEDICARE TYPE UNSPECIFIED | 8276 | 01 |
Other Name | Type Code |
---|---|
Primary Rx | Doing Business As Name - Organization |
Street Address |
2093 HENRY TECKLENBURG DR SUITE 300 |
City | CHARLESTON |
State | SC |
Zip Code | 29414-5741 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1184628935 | Kathryn Manning Hargrove | Obstetrics & Gynecology | 2093 Henry Tecklenburg Dr, Ste 207, Charleston, SC 29414-5741 | 2005-06-09 |
1760934087 | Alexander L Miller | Physician Assistant | 2093 Henry Tecklenburg Dr, Suite 200, Charleston, SC 29414-5741 | 2016-11-03 |
1427448273 | Sawyer Ann Langston | Physician Assistant | 2093 Henry Tecklenburg Dr, Suite 200, Charleston, SC 29414-5741 | 2015-02-02 |
1952706475 | Terri Southard | Counselor | 2093 Henry Tecklenburg Dr, Suite 202 East, Charleston, SC 29414-5741 | 2014-10-27 |
1134538986 | Roper Saint Francis Physicians Network | Internal Medicine | 2093 Henry Tecklenburg Dr, Suite 300e, Charleston, SC 29414 | 2014-08-06 |
1871923524 | Jessica Elizabeth Raux | Physician Assistant | 2093 Henry Tecklenburg Dr, Ste. 202e, Charleston, SC 29414-5741 | 2013-11-16 |
1891047205 | Roper Saint Francis Physicians Network | Orthopaedic Surgery | 2093 Henry Tecklenburg Dr, Suite 200, Charleston, SC 29414-5741 | 2012-10-09 |
1730457250 | Callie Rowland Powell | Registered Nurse | 2093 Henry Tecklenburg Dr, Suite 300, Charleston, SC 29414-5741 | 2011-12-12 |
1356620397 | Roper Saint Franics Physicians Network | Internal Medicine | 2093 Henry Tecklenburg Dr, Suite 202 East, Charleston, SC 29414-5741 | 2011-08-09 |
1245540277 | Roper Saint Francis Physicians Network | Surgery | 2093 Henry Tecklenburg Dr, Suite 202e, Charleston, SC 29414 | 2010-10-08 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1902444508 | Harris Teeter LLC | Durable Medical Equipment & Medical Supplies | 3865 West Ashley Circle, Charleston, SC 29414 | 2019-12-13 |
1215440169 | Christine Michelle Delcioppo | Nurse Practitioner | 2085 Henry Tecklenburg Dr Fl 2or2, Charleston, SC 29414 | 2017-11-14 |
1871013508 | Carolyn Sorenson | Assistant Behavior Analyst | 2218 Hunter Creek Dr, Charleston, SC 29414 | 2017-06-23 |
1205387354 | Rachel Klatt | Physical Therapist | 2230 Ashley Crossing Dr., Charleston, SC 29414 | 2016-10-24 |
1295286912 | Mary M Butler | Physical Therapy Assistant | 2230 Ashley Crossing Drive, Charleston, SC 29414 | 2016-10-18 |
1295104982 | Charlene Barbot | Registered Nurse | 3741 Clover St, Charleston, SC 29414 | 2015-09-23 |
1720467525 | Sasha M. Perez | Family Medicine | 3030 Ashley Town Center Dr Ste 102a, Charleston, SC 29414 | 2015-05-26 |
1104226240 | Angela Mcinvale | Counselor | 3030 Ashley Town Center Dr., Bldg. B-203, Charleston, SC 29414 | 2014-08-26 |
1659790087 | Catherine Jefferson Vanderwerker | Physical Therapist | 3019 Saintsbury Cove Dr, Charleston, SC 29414 | 2014-04-14 |
1104266741 | Elizabeth A Burguieres | Psychiatry & Neurology | Scdmh- Charleston Telepsychiatry Office, 706 Orleans Rd, Charleston, SC 29414 | 2013-06-27 |
Find all providers in zip 29414 |
Taxonomy Code | 207N00000X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Dermatology |
A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1700272978 | Leah Swanson | Dermatology | 135 Rutledge Ave # Msc578, Charleston, SC 29425-8903 | 2015-04-14 |
1770996621 | David Mark Perry | Dermatology | 48 Folly Road Blvd, Charleston, SC 29407-7507 | 2014-06-09 |
1891106811 | Sarah M. Derrington | Dermatology | 9217 University Blvd., Ste C1b, Charleston, SC 29406 | 2014-05-13 |
1649619404 | Richard Pierce | Dermatology | 776 Daniel Ellis Dr Ste 1a, Charleston, SC 29412-3095 | 2013-06-14 |
1528096831 | Brian Curtis Leach | Dermatology | 135 Rutledge Avenue, Dept of Dermatology & Dermatologic Surgery, Charleston, SC 29425 | 2006-06-28 |
1588629166 | Stephen Kirby Milroy | Dermatology | 3100 Mccorkle Ave Se, Ste 809, Charleston, WV 25304-1223 | 2006-04-18 |
1255393484 | James G Simpson | Dermatology | 48 Folly Road, Charleston, SC 29407 | 2006-04-04 |
1396713780 | Jeffrey K Mckenna | Dermatology | 100 Deerpath, Charleston, IL 61920-9427 | 2006-03-10 |
1689648123 | Erin Alyson Walker | Dermatology | 1364 Ashley River Rd, Charleston, SC 29407-5347 | 2006-02-13 |
1003893868 | Hudson C Rogers | Dermatology | 9295 Medical Plaza Dr, Suite B, Charleston, SC 29406-9137 | 2005-12-22 |
Find all providers in CHARLESTON |
City | CHARLESTON |
Zip Code | 29414 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.