Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Northeast Dermatology, PA

Organization Dermatology Physician · NPI 1154422558

Northeast Dermatology, PA provides Dermatology Physician services in Columbia, South Carolina. Licensed in South Carolina. Registered with an NPI since 2006.

Licensed in
SC
In the registry since
2006
What do these letters mean?
PA — Professional association
A form of business registration, not a clinical qualification.

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Practice location Address checks out

220 Graces Way
Columbia, SC 29229
Phone: (803) 736-4560
Fax: (803) 744-1217
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dermatology Physician (primary) Taxonomy 207N00000X · Licence 22975 (SC)

Record details

NPI number1154422558
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Lee Carson — President · (803) 736-4560
NPI enumeratedSeptember 26, 2006
Last updated in NPPESMarch 7, 2023
Mailing address220 Graces Way, Columbia, SC 29229

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