DERMATOLOGY ASSOCIATES OF COASTAL CAROLINA, PA (NPI# 1619903176) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619903176 |
| Entity Type | Organization |
| Organization Name | DERMATOLOGY ASSOCIATES OF COASTAL CAROLINA, PA |
| Practice Address |
2115 Neuse Blvd New Bern NC 28560-4309 |
| Mailing Address |
Po Box 890283 Charlotte NC 28289-0283 |
| Practice Telephone | 2526334461 |
| Practice Fax Number | 2526336016 |
| Mailing Telephone | 2526334461 |
| Mailing Fax Number | 2526336016 |
| Enumeration Date | 2006-06-24 |
| Last Update Date | 2013-02-19 |
| Authorized Official Name | DR. JAMES M POLO (MEDICAL DIRECTOR/OWNER) |
| Authorized Official Telephone | 2526334461 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207ND0900X |
Dermatology Specialization: Dermatopathology |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | BCBS GROUP PROVIDER NUMBE | 017RM | 01 |
| NC | RR MEDICARE | DF3377 | 01 |
| Street Address |
2115 NEUSE BLVD |
| City | NEW BERN |
| State | NC |
| Zip Code | 28560-4309 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104898717 | Sean James Murphy | Dermatology | 2115 Neuse Blvd, New Bern, NC 28560-4309 | 2006-02-07 |
| 1467810242 | Bradley William Alsip | Physician Assistant | 2115 Neuse Blvd, New Bern, NC 28560-4309 | 2016-02-08 |
| 1073902813 | Jamie Jones | Physician Assistant | 2115 Neuse Blvd, New Bern, NC 28560-4309 | 2015-01-16 |
| 1750662946 | Elizabeth Deibert Dryden | Physician Assistant | 2115 Neuse Blvd, New Bern, NC 28560-4309 | 2011-09-01 |
| 1952625592 | Catherine Alley Pollard | Physician Assistant | 2115 Neuse Blvd, New Bern, NC 28560-4309 | 2010-03-25 |
| 1609961853 | Scott David Mcclellan | Dermatology | 2115 Neuse Blvd, New Bern, NC 28560-4309 | 2006-10-04 |
| 1093731168 | James M Polo | Dermatology | 2115 Neuse Blvd, New Bern, NC 28560-4309 | 2006-07-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841898152 | Alec James Fields | Student in an Organized Health Care Education/Training Program | Cb 7121, 2086 Bondurant Hall, Chapel Hill, NC 28560 | 2020-10-09 |
| 1285270413 | Kelsey Miller | Social Worker | 2000 Doctor M.l.k. Jr Blvd, New Bern, NC 28560 | 2019-11-22 |
| 1568942399 | Siddharth Mourya | Physical Therapist | River Point Crest Nursing and Rehabilitation, 2600 Old Cherry Point Road, New Bern, NC 28560 | 2018-08-21 |
| 1194216713 | Genoa Healthcare, LLC | Pharmacy | 1309 Tatum Dr Ste 1, New Bern, NC 28560 | 2018-05-21 |
| 1134634561 | Eastern Carolina Young Men's Christian Association, Inc. | Health Educator | 100 Ymca Lane, New Bern, NC 28560 | 2017-12-07 |
| 1740725134 | Victoria Anne Sarbin | Audiologist | 2111 Neuse Blvd. Suite 1, New Bern, NC 28560 | 2016-12-21 |
| 1194193722 | Kriebel and Associates Pa | Clinic/Center | 3680 Neuse Blvd., New Bern, NC 28560 | 2015-09-14 |
| 1013308105 | Elizabeth Benton | Specialist | 3303 Highway 70 East, New Bern, NC 28560 | 2015-02-10 |
| 1386999068 | Allison Lang Snyder | Pharmacist | 1904 M L King Jr. Blvd., New Bern, NC 28560 | 2012-07-18 |
| 1144542606 | The Zannis Center for Plastic Surgery Pa | Clinic/Center | 2021 Neuse Blvd, New Bern, NC 28560 | 2010-02-24 |
| Find all providers in zip 28560 | ||||
| Taxonomy Code | 207ND0900X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| Specialization | Dermatopathology |
| A dermatopathologist has the expertise to diagnose and monitor diseases of the skin including infectious, immunologic, degenerative and neoplastic diseases. This entails the examination and interpretation of specially prepared tissue sections, cellular scrapings and smears of skin lesions by means of routine and special (electron and fluorescent) microscopes. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/; American Osteopathic Board of Dermatology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Dermatology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609961853 | Scott David Mcclellan | Dermatology | 2115 Neuse Blvd, New Bern, NC 28560-4309 | 2006-10-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073667077 | Earl George Gross | Dermatology | 3610 Medical Park Court, Morehead City, NC 28557 | 2007-01-23 |
| 1972591055 | Paul J Kostuchenko | Dermatology | 1345 Westgate Center Dr Ste B, Winston Salem, NC 27103-3041 | 2005-10-12 |
| 1588959894 | Dana Haydel | Dermatology | 706 Green Valley Rd Ste 104, Greensboro, NC 27408 | 2011-06-14 |
| 1821240995 | Westgate Dermatology and Laser Center, P.a. | Dermatology | 2020 Peace Haven Rd, Winston Salem, NC 27106-4851 | 2008-10-21 |
| 1841344843 | Crystal Coast Dermatology Services, Pa | Dermatology | 3610 Medical Park Court, Morehead City, NC 28557 | 2007-01-23 |
| 1962411017 | Hee Kim Park | Dermatology | 420 Spring Forest Rd, Greenville, NC 27834-7244 | 2006-08-07 |
| 1104847714 | Polley Clinic of Dermatology & Dermatologic Surgery | Dermatology | 1806 Glendale Dr Sw, Wilson, NC 27893-4402 | 2006-07-21 |
| 1255316311 | Rita O Pichardo-geisinger | Dermatology | 4618 Country Club Rd, Winston Salem, NC 27104-3520 | 2005-12-13 |
Please comment or provide details below to improve the information on DERMATOLOGY ASSOCIATES OF COASTAL CAROLINA, PA.
| 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.