Westgate Dermatology And Laser Center, P.A.

LBN: Westgate Dermatology And Laser Center, P.A.
Westgate Dermatology And Laser Center, P.A. is an health care organization with primary practice located at 2020 Peace Haven Rd , Winston Salem NC 27106-4851. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatopathology, which is considered as the primary health care specialty. Westgate Dermatology And Laser Center, P.A. can be contacted via phone (336) 768-1280, or through Kostuchenko, Paul J via phone (336) 768-1280.

Contact Information

Primary practice address
2020 Peace Haven Rd Winston Salem NC 27106-4851
Phone: (336) 768-1280
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Kostuchenko, Paul J Doctor of Medicine (MD)
Phone: (336) 768-1280

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatopathology 207ND0900X North Carolina

Profile Details

NPI number 1821240995
LBN Legal business name Westgate Dermatology And Laser Center, P.A.
DBA Doing business as
Authorized official Kostuchenko, Paul J Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Oct 21st, 2008
Last updated Oct 2nd, 2012 - about 14 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1821240995 NPPES
North Carolina Other QPB766 SC MEDICAID
North Carolina MEDICAID QPB766 SC MEDICAID
North Carolina MEDICAID 5950698 SC MEDICAID

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