NPI 1447911938

Advanced Dermatology of Sc PC

Organisation Dermatology Physician Fort Mill, SC

Practice location

Address: 1700 First Baxter Xing STE 101, Fort Mill, SC 29708-8950
Phone: (803) 802-3376
Fax: (803) 802-3329
Mailing address: 151 Southhall Ln STE 300, Maitland, FL 32751-7172

Authorised official

Name: Amy Declue
Title: Director Provider Enrollment
Phone: (407) 917-7293

Registered specialties

Dermatology Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207N00000X

Other Dermatology providers in South Carolina →

Registry record

NPI: 1447911938
Entity type: Organization
NPI issued: 6 Jan 2022
Record last updated: 6 Jan 2022

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.