Provider Demographics
NPI:1467582999
Name:BILTMORE DERMATOLOGY ASSOCIATES PA
Entity Type:Organization
Organization Name:BILTMORE DERMATOLOGY ASSOCIATES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:LISA
Authorized Official - Middle Name:D
Authorized Official - Last Name:NURRE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-232-5222
Mailing Address - Street 1:PO BOX 392
Mailing Address - Street 2:
Mailing Address - City:SYLVA
Mailing Address - State:NC
Mailing Address - Zip Code:28779-0392
Mailing Address - Country:US
Mailing Address - Phone:800-467-3381
Mailing Address - Fax:828-586-8209
Practice Address - Street 1:80 PEACHTREE RD STE 106
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28803-3180
Practice Address - Country:US
Practice Address - Phone:828-232-5222
Practice Address - Fax:828-258-3003
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-06
Last Update Date:2013-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9501031207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89012 5Medicaid
NC89012 5Medicaid
G42446Medicare UPIN