Basic Information
| Provider Information | |||||||||
| NPI: | 1184952897 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CURRENT DERMATOLOGY | ||||||||
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| Mailing Information | |||||||||
| Address1: | 61 BONNIE LN | ||||||||
| Address2: | |||||||||
| City: | SYLVA | ||||||||
| State: | NC | ||||||||
| PostalCode: | 287798511 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8286311852 | ||||||||
| FaxNumber: | 8286312534 | ||||||||
| Practice Location | |||||||||
| Address1: | 461 MOODY FARM RD | ||||||||
| Address2: | |||||||||
| City: | MAGGIE VALLEY | ||||||||
| State: | NC | ||||||||
| PostalCode: | 287519684 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8286311852 | ||||||||
| FaxNumber: | 8286312534 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/19/2009 | ||||||||
| LastUpdateDate: | 11/19/2009 | ||||||||
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| AuthorizedOfficialLastName: | MARTIKAINEN | ||||||||
| AuthorizedOfficialFirstName: | RUTH | ||||||||
| AuthorizedOfficialMiddleName: | E | ||||||||
| AuthorizedOfficialTitleorPosition: | OFFICE ASSISTANT | ||||||||
| AuthorizedOfficialTelephone: | 8286311852 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207N00000X | 2008-01562 | NC | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Dermatology |
No ID Information.