Island Park Dermatology LLC
NPI 1194436956ActiveOrganization· Dermatology· Daniel Island, SC
Dermatology in Daniel Island, South Carolina, registered in NPPES in December 2022. The authorized official on file is Cynthia Irby Wilson, MD, Owner. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1194436956 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Dec 12, 2022 |
| Last updated in NPPES | Dec 12, 2022 |
| Certified by provider | Dec 12, 2022 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dermatology Primary | 207N00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (SC) |
|---|
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