BLUEWATER DERMATOLOGY AND SKIN CANCER CENTER PA – NPI #1245751403
Dermatology

The highly-trained surgeons that perform Mohs Micrographic Surgery are specialists both in dermatology and pathology. With their extensive knowledge of the skin and unique pathological skills, they are able to remove only diseased tissue, preserving healthy tissue and minimizing the cosmetic impact of the surgery. Mohs surgeons who belong to the American College of Mohs Surgery (ACMS) have completed a minimum of one year of fellowship training at one of the ACMS-approved training centers in the U.S.

Health Care Provider Taxonomy Code for Dermatology

BLUEWATER DERMATOLOGY AND SKIN CANCER CENTER PA is a dermatologist located in LELAND, NC. NPPES has assigned the NPI number 1245751403 to BLUEWATER DERMATOLOGY AND SKIN CANCER CENTER PA on June 28, 2017. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 207ND0101X from the Health Care Provider Taxonomy code set, which is classified as Dermatology, specializing in MOHS-Micrographic Surgery

The NPI profile was previously updated about 5 years ago on Nov 01, 2021. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for BLUEWATER DERMATOLOGY AND SKIN CANCER CENTER PA below.

NPI Profile for
BLUEWATER DERMATOLOGY AND SKIN CANCER CENTER PA

NPI Number
1245751403
Enumeration Date

(about 9 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
BLUEWATER DERMATOLOGY AND SKIN CANCER CENTER PA
Primary location
144 POOLE RD STE 101
LELAND, NC 28451-9504
Phone: (910) 262-1048 Fax: (910) 256-6039
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
THOMAS BRAZA
PRESIDENT
Phone: (910) 640-0899
Updated
Certification Date
Nov 01, 2021

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
207ND0101X
- Dermatology / MOHS-Micrographic Surgery (Primary)		 NC 2012-00516

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.