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

Sanford Dermatology PLLC

Organization Dermatology Physician · NPI 1205240868

Sanford Dermatology PLLC is a Dermatology Physician in Sanford, North Carolina. Registered with an NPI since 2014.

In the registry since
2014
Specialties on file
2
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1911 K M Wicker Memorial Dr
Sanford, NC 27330-5070
Phone: (919) 775-7926
Fax: (919) 718-0092
Show map & directions

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

Specialties & licences

Dermatology Physician (primary) Taxonomy 207N00000X
Physician Assistant Taxonomy 363A00000X

Record details

NPI number1205240868
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jeffrey Queen — Manager · (561) 314-2000
NPI enumeratedJune 11, 2014
Last updated in NPPESNovember 8, 2024
Certification dateNovember 8, 2024
Mailing address4700 Exchange Ct Ste 110, Boca Raton, FL 33431-4450

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