Provider Demographics
NPI:1205856077
Name:VIEWMONT DERMATOLOGY PA
Entity Type:Organization
Organization Name:VIEWMONT DERMATOLOGY PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:CARYON
Authorized Official - Middle Name:M
Authorized Official - Last Name:RAMSEUR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-261-2060
Mailing Address - Street 1:304 10TH AVE NE
Mailing Address - Street 2:STE 101
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28601-3834
Mailing Address - Country:US
Mailing Address - Phone:828-261-2060
Mailing Address - Fax:828-261-2067
Practice Address - Street 1:304 10TH AVE NE
Practice Address - Street 2:101
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28601-3834
Practice Address - Country:US
Practice Address - Phone:828-261-2060
Practice Address - Fax:828-261-2067
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-21
Last Update Date:2008-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2345044Medicare ID - Type Unspecified