Provider Demographics
NPI:1730323601
Name:CURRENT DERMATOLOGY
Entity Type:Organization
Organization Name:CURRENT DERMATOLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:CURRENT
Authorized Official - Middle Name:PATTERSON
Authorized Official - Last Name:CUSTER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:614-446-2272
Mailing Address - Street 1:61 BONNIE LANE
Mailing Address - Street 2:
Mailing Address - City:SYLVA
Mailing Address - State:NC
Mailing Address - Zip Code:28779
Mailing Address - Country:US
Mailing Address - Phone:828-631-1852
Mailing Address - Fax:
Practice Address - Street 1:61 BONNIE LANE
Practice Address - Street 2:
Practice Address - City:SYLVA
Practice Address - State:NC
Practice Address - Zip Code:28779
Practice Address - Country:US
Practice Address - Phone:828-631-1852
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-23
Last Update Date:2012-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2008-01562261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2073665AMedicare PIN