Carolina Dermatology Clinic, Pa

LBN: Carolina Dermatology Clinic, Pa
Carolina Dermatology Clinic, Pa is an health care organization with primary practice located at 933 Saint Andrews Blvd , Charleston SC 29407. The organization recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Dermatology. Allopathic & Osteopathic Physicians / Dermatology is the primary health care specialty. Carolina Dermatology Clinic, Pa can be contacted via phone (843) 766-9868, or through Kotz, Edward A. via phone (843) 766-9868.

Contact Information

Primary practice address
933 Saint Andrews Blvd Charleston SC 29407
Phone: (843) 766-9868
Fax: (843) 571-4925
Website:
Map and Directions
Authorized official contact:
Name: Kotz, Edward A. Doctor of Medicine (MD)
Phone: (843) 766-9868

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 24039 South Carolina
Allopathic & Osteopathic Physicians / Dermatology 207N00000X 24039 South Carolina

Profile Details

NPI number 1639202294
LBN Legal business name Carolina Dermatology Clinic, Pa
DBA Doing business as
Authorized official Kotz, Edward A. Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Mar 13th, 2007
Last updated Jan 18th, 2011 - about 15 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1639202294 NPPES
South Carolina MEDICAID 240395
South Carolina MEDICAID GROUPGP4945

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