Registry details
Type
Individual
Primary specialty
Dermatology
Enumerated
Jan 17, 2006
License(s)
MD 60313749 (WA), MD60313749 (WA), 200501773 (NC)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 6781 PARKER FARM DR STE 300 | Wilmington, NC 28405-3161 | 910-763-1555 |
| MAILING | 6781 PARKER FARM DR STE 300 | Wilmington, NC 28405-3161 | 910-763-1555 |
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