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

South Charleston Dermatology PLLC

Organization Dermatology Physician · NPI 1174604409

South Charleston Dermatology PLLC is a Dermatology Physician in South Charleston, West Virginia. Licensed in West Virginia. Registered with an NPI since 2006.

Licensed in
WV
In the registry since
2006
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Practice location Address checks out

4815 Kanawha Ave SW
South Charleston, WV 25309-1207
Phone: (304) 768-4567
Fax: (304) 768-2277
Show map & directions

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

Specialties & licences

Dermatology Physician (primary) Taxonomy 207N00000X · Licence 2097 (WV)

Record details

NPI number1174604409
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Michelle Endicott — Owner/Physician · (304) 768-4567
NPI enumeratedOctober 17, 2006
Last updated in NPPESDecember 12, 2011
Mailing address4815 Kanawha Ave Sw, South Charleston, WV 25309-1207

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