Sanford Dermatology PLLC
NPI 1205240868ActiveOrganization· Dermatology· Sanford, NC
Dermatology in Sanford, North Carolina, registered in NPPES in June 2014. The authorized official on file is Jeffrey D. Queen, Manager. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1205240868 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jun 11, 2014 |
| Last updated in NPPES | Nov 8, 2024 |
| Certified by provider | Nov 8, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dermatology Primary | 207N00000X | — | — |
| Physician Assistant | 363A00000X | — | — |
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 (NC) |
|---|
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