Provider Demographics
NPI:1871893503
Name:REGIONAL DERMATOLOGY OF DURHAM
Entity type:Organization
Organization Name:REGIONAL DERMATOLOGY OF DURHAM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:H
Authorized Official - Last Name:HAMILTON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:919-220-7546
Mailing Address - Street 1:4321 MEDICAL PARK DR
Mailing Address - Street 2:SUITE 102
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27704-2199
Mailing Address - Country:US
Mailing Address - Phone:919-220-7546
Mailing Address - Fax:919-220-5805
Practice Address - Street 1:4321 MEDICAL PARK DR
Practice Address - Street 2:SUITE 102
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27704-2199
Practice Address - Country:US
Practice Address - Phone:919-220-7546
Practice Address - Fax:919-220-5805
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-28
Last Update Date:2011-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty