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

West Virginia Dermatology and Skin Surgery Center

Organization Medical Specialty Clinic/Center · NPI 1174881916

West Virginia Dermatology and Skin Surgery Center is a Medical Specialty Clinic/Center in South Charleston, West Virginia. Licensed in West Virginia. Registered with an NPI since 2012.

Licensed in
WV
In the registry since
2012

Practice location Address checks out

4202 Maccorkle Ave SW Ste 200
South Charleston, WV 25309-1513
Phone: (304) 925-7546
Fax: (681) 205-8369
Show map & directions

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

Specialties & licences

Medical Specialty Clinic/Center (primary) Taxonomy 261QM2500X · Licence 2596 (WV)

Record details

NPI number1174881916
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official David Judy — Owner · (304) 925-7546
Other names West Virginia Dermatology; West Virginia Dermatology
NPI enumeratedApril 30, 2012
Last updated in NPPESJanuary 6, 2020
Certification dateJanuary 6, 2020
Mailing address4202 Maccorkle Ave Sw Ste 200, South Charleston, WV 25309-1513

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