DERMATOLOGY AND SKIN CANCER CENTER OF SOUTH CAROLINA PC (NPI# 1073946315) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073946315 |
| Entity Type | Organization |
| Organization Name | DERMATOLOGY AND SKIN CANCER CENTER OF SOUTH CAROLINA PC |
| Practice Address |
5046 Highway 17 Byp S Suite 103 Myrtle Beach SC 29588-4503 |
| Practice Telephone | 8436684104 |
| Practice Fax Number | 2018488902 |
| Mailing Telephone | 8436884104 |
| Mailing Fax Number | 2018488902 |
| Enumeration Date | 2013-08-09 |
| Last Update Date | 2013-10-11 |
| Authorized Official Name | JOSPEH M MASESSA (PRESIDENT) |
| Authorized Official Telephone | 8436684104 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207N00000X | Dermatology | MD35615 | SC | Allopathic & Osteopathic Physicians |
| N | 207ND0900X |
Dermatology Specialization: Dermatopathology |
MD35615 | SC | Allopathic & Osteopathic Physicians |
| N | 207NI0002X |
Dermatology Specialization: Clinical & Laboratory Dermatological Immunology |
MD35615 | SC | Allopathic & Osteopathic Physicians |
| N | 207NS0135X |
Dermatology Specialization: Procedural Dermatology |
MD35615 | SC | Allopathic & Osteopathic Physicians |
| Y | 207ND0101X |
Dermatology Specialization: MOHS-Micrographic Surgery |
MD35615 | SC | Allopathic & Osteopathic Physicians |
| Street Address |
5046 HIGHWAY 17 BYP S SUITE 103 |
| City | MYRTLE BEACH |
| State | SC |
| Zip Code | 29588-4503 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649269085 | Grand Strand Senior Health Center, LLC | Internal Medicine | 5046 Highway 17 Byp S, Suite 100, Myrtle Beach, SC 29588-4503 | 2005-10-18 |
| 1124481296 | Veritas Executive Healthcare | Internal Medicine | 5046 Highway 17 Byp S, Suite 100, Myrtle Beach, SC 29588-4503 | 2016-04-05 |
| 1720449036 | All About Therapy, LLC | Physical Therapist | 5046 Highway 17 Byp S, Suite 205, Myrtle Beach, SC 29588-4503 | 2016-03-14 |
| 1700290129 | Cassie Mcdonald Barkley | Specialist/Technologist | 5046 Highway 17 Byp S, Suite 202 and 203, Myrtle Beach, SC 29588-4503 | 2014-06-13 |
| 1659797306 | Taylor J Rowe | Physical Therapist | 5046 Highway 17 Byp S, Unit 201, Myrtle Beach, SC 29588-4503 | 2014-03-05 |
| 1114341278 | Strand Endocrinology,llc | Internal Medicine | 5046 Highway 17 Byp S, Suite 104, Myrtle Beach, SC 29588-4503 | 2014-02-10 |
| 1124442611 | Veritas Healthcare Solutions, LLC | Internal Medicine | 5046 Highway 17 Byp S, Suite 100, Myrtle Beach, SC 29588-4503 | 2014-02-05 |
| 1578908950 | Amanda Beth Belesky | Physician Assistant | 5046 Highway 17 Byp S, Suite 100, Myrtle Beach, SC 29588-4503 | 2013-04-30 |
| 1912191818 | Javaid H Wani | Internal Medicine | 5046 Highway 17 Byp S, Suite 104, Myrtle Beach, SC 29588-4503 | 2007-09-04 |
| 1114131356 | Mary B Kelly | Nurse Practitioner | 5046 Highway 17 Byp S, Suite 202 and Suite 203, Myrtle Beach, SC 29588-4503 | 2007-05-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740819309 | Forrest Halsey Westley | Pharmacist | 3072 Dick Pond Rd. Suite 2, Myrtle Beach, SC 29588 | 2020-04-06 |
| 1588124176 | The Counseling Center of Sayebrook | Counselor | 106 Lansford Court Suite 202, Myrtle Beach, SC 29588 | 2019-03-21 |
| 1134631443 | Solid Foundations, LLC | Clinic/Center | 4325 Dick Pond Road, Suite E, Myrtle Beach, SC 29588 | 2017-10-26 |
| 1316496037 | Grand Strand Rehab and Nursing Center, LLC | Skilled Nursing Facility | 4452 Socastee Boulevard, Myrtle Beach, SC 29588 | 2016-09-22 |
| 1386092039 | Eyemart Express LLC | Eyewear Supplier (Equipment, not the service) | 1370 South Commons Drive, Suite 102, Myrtle Beach, SC 29588 | 2016-06-02 |
| 1114314531 | Allison Smith | Physical Therapy Assistant | 4870 Socastee Blvd, Myrtle Beach, SC 29588 | 2015-04-23 |
| 1760806160 | Myrtle Beach Physical Medicine & Rehab, LLC | Family Medicine | 4736 17 Bypass South, Myrtle Beach, SC 29588 | 2014-02-06 |
| 1801228499 | Robin Ruth Gause | Lactation Consultant, Non-RN | 510 Fairwood Lakes Ave, 14-c, Myrtle Beach, SC 29588 | 2013-08-06 |
| 1124386438 | Horace Earl Ferguson Jr. | Technician/Technologist | 4535 Dick Pond Road, A, Myrtle Beach, SC 29588 | 2012-04-25 |
| 1831463652 | Medeyecare, LLC | Technician/Technologist | 4335 Socastee Blvd, Unit A, Myrtle Beach, SC 29588 | 2012-02-24 |
| Find all providers in zip 29588 | ||||
| Taxonomy Code | 207ND0101X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| Specialization | MOHS-Micrographic Surgery |
| The highly-trained surgeons that perform Mohs Micrographic Surgery are specialists both in dermatology and pathology. With their extensive knowledge of the skin and unique pathological skills, they are able to remove only diseased tissue, preserving healthy tissue and minimizing the cosmetic impact of the surgery. Mohs surgeons who belong to the American College of Mohs Surgery (ACMS) have completed a minimum of one year of fellowship training at one of the ACMS-approved training centers in the U.S. |
| Notes: Source: American College of Mohs Surgery, 2007 [1/1/2008: added definition, added source] Additional Resources: Additional Resources: http://www.mohscollege.org/; American Board of Dermatology, 2007. http://www.abderm.org/ |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174122444 | Coastal Dermatology Institute LLC | Dermatology | 920 Doug White Dr Ste 310, Myrtle Beach, SC 29572-4180 | 2020-10-19 |
| 1992065858 | Brandon James Coakley | Dermatology | 917 Medical Cir, Myrtle Beach, SC 29572-4116 | 2012-05-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639254014 | Hilton Head Dermatology and Skin Cancer Center Pa | Dermatology | 15 Hospital Center Blvd Ste 1, Hilton Head, SC 29926-2760 | 2006-10-26 |
| 1396777124 | James R Debloom II | Dermatology | 300 Ashby Park Lane, Greenville, SC 29607-6903 | 2006-07-06 |
| 1801825468 | Dermatology Associates of The Lowcountry | Dermatology | 108 Medical Park Dr, Walterboro, SC 29488-5719 | 2006-07-03 |
| 1215989587 | Robert Marshall Rogers | Dermatology | 213 Mills Ave, Greenville, SC 29605-4019 | 2006-05-16 |
| 1083693857 | Carolina Dermatology Grp | Dermatology | 1706 St Julians Place, Columbia, SC 29204-2410 | 2006-01-11 |
| 1427059997 | Richard John Deangelis | Dermatology | 1409 N Fant St, Anderson, SC 29621-4825 | 2005-08-09 |
| 1851810279 | Skin Surgery Center Pa | Dermatology | 180 Wingo Way Ste 202, Mount Pleasant, SC 29464-1811 | 2017-09-18 |
| 1447575931 | Jane Unaeze | Dermatology | 920 Woodruff Rd, Greenville, SC 29607-4105 | 2010-03-29 |
| 1376757427 | Skin Cancer Centre, P. A. | Dermatology | 1409 N Fant St, Anderson, SC 29621-4825 | 2007-05-09 |
| 1417089376 | Germain Dermatology, Pa | Dermatology | 612 Seacoast Pkwy, Suite 201, Mount Pleasant, SC 29464-8247 | 2007-03-09 |
| Find all providers with the same taxonomy | ||||
| City | MYRTLE BEACH |
| Zip Code | 29588 |
Please comment or provide details below to improve the information on DERMATOLOGY AND SKIN CANCER CENTER OF SOUTH CAROLINA PC.
| 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.