Provider Demographics
NPI:1841277399
Name:AIKEN DERMATOLOGY & SKIN CANCER CLINIC
Entity type:Organization
Organization Name:AIKEN DERMATOLOGY & SKIN CANCER CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:H
Authorized Official - Last Name:FITCH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:803-649-3909
Mailing Address - Street 1:1520 TWO NOTCH RD SE
Mailing Address - Street 2:
Mailing Address - City:AIKEN
Mailing Address - State:SC
Mailing Address - Zip Code:29803-5551
Mailing Address - Country:US
Mailing Address - Phone:803-649-3909
Mailing Address - Fax:803-642-8495
Practice Address - Street 1:1520 TWO NOTCH RD SE
Practice Address - Street 2:
Practice Address - City:AIKEN
Practice Address - State:SC
Practice Address - Zip Code:29803-5551
Practice Address - Country:US
Practice Address - Phone:803-649-3909
Practice Address - Fax:803-642-8495
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2010198207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC101981Medicaid
SC101981Medicaid
D90844Medicare UPIN