PC DERMATOLOGY PLLC (NPI# 1366086597) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366086597 |
| Entity Type | Organization |
| Organization Name | PC DERMATOLOGY PLLC |
| Practice Address |
118 Gateway Blvd Ste A Mooresville NC 28117-6542 |
| Practice Telephone | 7042301302 |
| Practice Fax Number | 7042301284 |
| Mailing Telephone | 7042301302 |
| Mailing Fax Number | 7042301284 |
| Enumeration Date | 2019-10-31 |
| Last Update Date | 2020-08-10 |
| Authorized Official Name | DR. BISHR AL DABAGH (OWNER) |
| Authorized Official Telephone | 2163757542 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207ND0101X |
Dermatology Specialization: MOHS-Micrographic Surgery |
Allopathic & Osteopathic Physicians | ||
| N | 207NS0135X |
Dermatology Specialization: Procedural Dermatology |
Allopathic & Osteopathic Physicians | ||
| Y | 207N00000X | Dermatology | Allopathic & Osteopathic Physicians |
| Street Address |
118 GATEWAY BLVD STE A |
| City | MOORESVILLE |
| State | NC |
| Zip Code | 28117-6542 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477605442 | John Scott Keadle | Dentist | 118 Gateway Blvd Ste A, Mooresville, NC 28117-6542 | 2007-01-18 |
| 1154565661 | Bishr Al Dabagh | Dermatology | 118 Gateway Blvd Ste A, Mooresville, NC 28117-6542 | 2009-04-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891356648 | Teleoptometric Service, P.C. | Optometrist | 392 Talbert Rd, Mooresville, NC 28117 | 2019-06-24 |
| 1992268544 | Costco Wholesale Corporation | Eyewear Supplier (Equipment, not the service) | 392 Talbert Rd., Mooresville, NC 28117 | 2019-04-10 |
| 1982178042 | Langtree Endoscopy Center, LLC | Clinic/Center | 106 Alexander Bank Drive, Suite 101, Mooresville, NC 28117 | 2019-01-11 |
| 1679044416 | May and Associates Therapy Center | Psychologist | 862 Brawley School Road, Suite 202, Mooresville, NC 28117 | 2018-12-05 |
| 1700360153 | Sabrina Chabot Hutchinson | Physical Therapist | 508 Williamson Rd, Suite 200, Mooresville, NC 28117 | 2018-09-21 |
| 1992284327 | Presbyterian Imaging Centers LLC | Radiology | 106 Langtree Village Dr # 201, Mooresville, NC 28117 | 2018-08-07 |
| 1073091310 | Jenelle Donzelli Nemeth | Registered Nurse | 102 Sapphire Drive, Mooresville, NC 28117 | 2018-07-30 |
| 1912497496 | Patsharx LLC | Pharmacy | 480 River Hwy, Suite A, Mooresville, NC 28117 | 2018-05-10 |
| 1427502434 | Counseling Service At Lake Norman, Pllc | Community/Behavioral Health | 18117 W. Catawba Avenue, Cornelius, NC 28117 | 2016-08-08 |
| 1447605928 | Renewal Counseling, Pllc | Counselor | 125 Commerce Park Rd., Suite 102, Mooresville, NC 28117 | 2016-05-03 |
| Find all providers in zip 28117 | ||||
| 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 |
|---|---|---|---|---|
| 1902469570 | Falling Leaves Dermatology Mooresville LLC | Dermatology | 136 Corporate Park Dr Ste H, Mooresville, NC 28117-6960 | 2019-04-18 |
| 1720039399 | Joel H Sugarman | Dermatology | 140 Leaning Oak Drive, Ste 101, Mooresville, NC 28117-6991 | 2006-05-16 |
| 1528047404 | Steven F Wolfe | Dermatology | 114 Gateway Blvd, Unit D, Mooresville, NC 28117-5540 | 2006-01-10 |
| 1154565661 | Bishr Al Dabagh | Dermatology | 118 Gateway Blvd Ste A, Mooresville, NC 28117-6542 | 2009-04-28 |
| 1831218031 | Naomi Soroosh Simon | Dermatology | 128 Medical Park Rd, Suite 201, Mooresville, NC 28117-8578 | 2007-03-28 |
| 1184754848 | Lake Norman Dermatology, Pa | Dermatology | 140 Leaning Oak Drive, Ste 101, Mooresville, NC 28117-6991 | 2007-03-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043811128 | Foothills Family Dermatology | Dermatology | 118 North Sterling St, Morganton, NC 28655 | 2020-11-04 |
| 1316556871 | Easterm Dermatology, Pa | Dermatology | 1840 Nc Hwy 24, Newport, NC 28570 | 2020-07-30 |
| 1548878549 | Clara Dermatology | Dermatology | 7250 O'kelly Chapel Road, Suite 100, Cary, NC 27519 | 2020-07-16 |
| 1841837507 | Southeast Vulvar Clinic, Pllc | Dermatology | 6406 Carmel Road, Suite 309, Charlotte, NC 28226 | 2019-12-02 |
| 1205481009 | Novant Medical Group Inc | Dermatology | 6324 Fairview Rd # 200, Charlotte, NC 28210-3271 | 2019-08-08 |
| 1073172433 | Elaine Otchere | Dermatology | M145 Green Zone Duke South 40 Duke Medicine Circle, Durham, NC 27710-8267 | 2019-06-10 |
| 1669945259 | Claire Engel Holmquist | Dermatology | 11301 Golf Links Dr N Ste 203, Charlotte, NC 28277-8014 | 2019-01-07 |
| 1497227144 | Integrated Dermatology of North Carolina, Pllc | Dermatology | 10512 Park Rd Ste 113, Charlotte, NC 28210-8469 | 2018-12-19 |
| 1558848093 | Dermatology Consultants of Asheville Pllc | Dermatology | 218 Elkwood Ave # 104, Woodfin, NC 28804-2247 | 2018-07-27 |
| 1447748819 | Integrated Dermatology of North Raleigh, Pllc | Dermatology | 3809 Computer Dr Ste 200, Raleigh, NC 27609 | 2018-05-01 |
| Find all providers with the same taxonomy | ||||
| City | MOORESVILLE |
| Zip Code | 28117 |
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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.