NORTHEAST DERMATOLOGY, PA
Dermatology at Graces Way, Columbia, SC

License number
South Carolina 22975
Category
Osteopathic Medicine
Type
Dermatology
Owner
Name: DR. LEE SMITH CARSON M.D.
Title: PRESIDENT
Phone: (803) 736-4560
Address
Address
220 Graces Way, Columbia, SC 29229
National Provider ID: 1154422558
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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NORTHEAST DERMATOLOGY, PA

Columbia, SC

Industry:
Osteopathic Physician's Office Medical Doctor's Office
Registration:
Jul 11, 2006
Addresses:
220 Grace's Way, Columbia, SC 29229 (Physical)
220 Graces Way, Columbia, SC 29229
Business type:
Domestic
Formation place:
SOUTH CAROLINA
Physician Assistants:
Lee S. Carson (Chief Executive Officer, Dermatology, Medical Doctor, Principal),Carrie L. Powers (Physician Assistant),Marie Harmon (Insurance/billing Supervisor),...
Agent:
Lee Smith Carson Md Ph.d

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