Provider Demographics
NPI:1235531906
Name:HIGHLANDS DERMATOLOGY PA
Entity Type:Organization
Organization Name:HIGHLANDS DERMATOLOGY PA
Other - Org Name:PAUL S CABIRAN
Other - Org Type:Other Name
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:TANDY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-526-1232
Mailing Address - Street 1:209 HOSPITAL DR
Mailing Address - Street 2:SUITE 302
Mailing Address - City:HIGHLANDS
Mailing Address - State:NC
Mailing Address - Zip Code:28741-7623
Mailing Address - Country:US
Mailing Address - Phone:828-526-1232
Mailing Address - Fax:828-526-9988
Practice Address - Street 1:209 HOSPITAL DR
Practice Address - Street 2:SUITE 302
Practice Address - City:HIGHLANDS
Practice Address - State:NC
Practice Address - Zip Code:28741-7623
Practice Address - Country:US
Practice Address - Phone:828-526-1232
Practice Address - Fax:828-526-9988
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-24
Last Update Date:2014-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC203895207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty