SKIN CANCER & COSMETIC DERMATOLOGY CENTER, PC (NPI# 1376605394) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376605394 |
| Entity Type | Organization |
| Organization Name | SKIN CANCER & COSMETIC DERMATOLOGY CENTER, PC |
| Practice Address |
1107 Memorial Drive Suite 201 Dalton GA 30720 |
| Mailing Address |
1107 Memorial Dr Suite 201 Dalton GA 30720-8662 |
| Practice Telephone | 7062777311 |
| Practice Fax Number | 7062723512 |
| Mailing Telephone | 7062777311 |
| Mailing Fax Number | 7062723512 |
| Enumeration Date | 2006-12-15 |
| Last Update Date | 2011-01-25 |
| Authorized Official Name | MS. KELLEY FINNELL (PRACTICE MANAGER) |
| Authorized Official Telephone | 7062777311 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | MEDICARE GROUP | GRP4446 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144419458 | Skin Cancer & Cosmetic Dermatology Center, PC | Specialist | 2253 Chambliss Ave Nw, Suite 202, Cleveland, TN 37311-3861 | 2007-10-23 |
| Street Address |
1107 MEMORIAL DRIVE SUITE 201 |
| City | DALTON |
| State | GA |
| Zip Code | 30720 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417992488 | Patricia A Allen | Pathology | 1107 Memorial Drive, Suite 201, Dalton, GA 30720-8662 | 2006-06-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528688421 | Nighat Purnima Kabir | Student in an Organized Health Care Education/Training Program | Hamilton Medical Center, Attn: Residency Program, 1200 Memorial Drive, Dalton, GA 30720 | 2020-04-21 |
| 1720620727 | Elizabeth Nicole Gregory | Behavioral Analyst | 1201 Burleyson Rd., Dalton, GA 30720 | 2019-10-10 |
| 1972161768 | Andrea Nicole Henry | Speech-Language Pathologist | 1201 Burleyson Road, Dalton, Ga. 30720, Dalton, GA 30720 | 2019-06-05 |
| 1275056905 | Cynthia L Wood | Speech-Language Pathologist | 1011 Professional Blvd., Dalton, GA 30720 | 2017-07-25 |
| 1073069225 | Alyssa Sellers Garner | Nurse Practitioner | 1436 Chattanooga Avenue, Dalton, GA 30720 | 2016-08-28 |
| 1588039077 | Katie Walker | Social Worker | 900 Shugart Road, Dalton, GA 30720 | 2015-12-09 |
| 1215310800 | Wal-mart Stores East Lp | Durable Medical Equipment & Medical Supplies | 98 West Walnut Ave, Dalton, GA 30720 | 2015-07-01 |
| 1275969081 | Stacy Kay Whitehead | Nurse Practitioner | 1411 Chattanooga Avenue, Suite 101, Dalton, GA 30720 | 2013-09-25 |
| 1821439985 | Chantal Aneka Raheeda Lewis | Internal Medicine | 1109 Burleyson Rd Ste 103, Dalton, GA 30720 | 2013-07-17 |
| 1174960678 | Homestead Hospice of Northwest Georgia, LLC | Hospice Care, Community Based | 1601 Hickory Street, Dalton, GA 30720 | 2013-05-24 |
| Find all providers in zip 30720 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639709256 | Integrated Healthcare Center of Dalton, LLC | Specialist | 1513 W Walnut Ave, Dalton, GA 30720-3869 | 2020-01-23 |
| 1346489515 | Hollie Nicole Cope | Specialist | 110 W Crawford St, Suite 201, Dalton, GA 30720-4201 | 2009-02-11 |
| 1912059833 | Leland Sage Duddleston IIi | Specialist | 1000 Riverburch Pkwy, Dalton, GA 30721-8630 | 2007-01-18 |
| 1336218379 | James Gregory | Specialist | 606 Mount Sinai Rd, Dalton, GA 30720-3749 | 2006-11-06 |
| 1891891560 | Juan Carlos Gonzalez | Specialist | 1107 Memorial Dr Ste 102, Dalton, GA 30720-8662 | 2006-09-16 |
| 1609809813 | Rajiv Verma | Specialist | 1600 Broadrick Dr, Dalton, GA 30720-3012 | 2006-07-09 |
| 1275589996 | Riad Al-sayed Ahmad | Specialist | 1610 Broadrick Dr, Dalton, GA 30720-3012 | 2006-05-25 |
| 1932179983 | Robert Alan Pedersen | Specialist | 1505 Professional Ct, Dalton, GA 30720-2500 | 2006-01-24 |
| 1750372561 | Shaheen P Noorani | Specialist | 1210 Broadrick Dr, Suite 1, Dalton, GA 30720-2676 | 2005-11-01 |
| 1366438905 | Philip Bates Bailey | Specialist | 1436 Broadrick Dr, Suite B, Dalton, GA 30720-3009 | 2005-09-20 |
| Find all providers in DALTON | ||||
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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.