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

Dermatology Associates of Coastal Carolina

Organization Clinical & Laboratory Dermatological Immunology Physician · NPI 1033459011

Dermatology Associates of Coastal Carolina is a Clinical & Laboratory Dermatological Immunology Physician in Jacksonville, North Carolina. Registered with an NPI since 2013.

In the registry since
2013

Practice location Address checks out

2145 Country Club Rd
Jacksonville, NC 28546-2403
Phone: (252) 633-4461
Fax: (252) 633-6016
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical & Laboratory Dermatological Immunology Physician (primary) Taxonomy 207NI0002X

Record details

NPI number1033459011
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official James Polo — Md/Owner · (252) 633-4461
NPI enumeratedFebruary 27, 2013
Last updated in NPPESSeptember 21, 2022
Certification dateSeptember 21, 2022
Mailing addressPo Box 890283, Charlotte, NC 28289-0283