Southern Dermatology Center, PC
NPI 1336172634ActiveOrganization· Dermatology· Decatur, AL
Dermatology in Decatur, Alabama, registered in NPPES in July 2006. The authorized official on file is Angelo Mancuso, DO, Owner. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1336172634 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jul 9, 2006 |
| Last updated in NPPES | Apr 7, 2009 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dermatology Primary | 207N00000X | D0196 | AL |
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 (AL) |
|---|
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