SOUTH CHARLESTON DERMATOLOGY PLLC
NPI 1174604409
Dermatology in South Charleston, WV

Active since October 17, 2006
4815 KANAWHA AVE SW, SOUTH CHARLESTON, WV 25309(304) 768-4567(304) 768-2277 Get Directions Write a Review

NPPES record last updated: December 12, 2011. Verified against the NPPES registry weekly; last sync: August 30, 2026.

About South Charleston Dermatology Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SOUTH CHARLESTON DERMATOLOGY PLLC (NPI 1174604409) is a healthcare organization registered as a dermatology in South Charleston, West Virginia and active in the NPI registry since October 2006. The organization lists Michelle Leigh Endicott, Owner/physician, as its authorized official.

NPPES Registry Identity

NPI1174604409
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameSOUTH CHARLESTON DERMATOLOGY PLLC
Location Address4815 KANAWHA AVE SWSouth Charleston, WV 25309-1207
Mailing Address4815 Kanawha Ave SwSouth Charleston, WV 25309-1207 · (304) 768-4567 · Fax (304) 768-2277
Fax(304) 768-2277
Organization SubpartNo
Authorized OfficialMichelle Leigh EndicottOwner/physician · (304) 768-4567
Enumeration DateOctober 17, 2006
Last NPPES UpdateDecember 12, 2011
NPI 1174604409 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207N00000X
License Licensed in WV · 2097
Definition
A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.
4815 KANAWHA AVE SW, South Charleston, WV 25309

Other Identifiers 1

Medicare ID-Type Unspecified9355431WV · Medicare Group Number

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Physician Assistant
4815 KANAWHA AVE SW
SOUTH CHARLESTON, WV 25309
Physician Assistant (Medical)
4815 KANAWHA AVE SW
SOUTH CHARLESTON, WV 25309
Dermatology
4815 KANAWHA AVE SW
SOUTH CHARLESTON, WV 25309
Dermatology
4815 KANAWHA AVE SW
SOUTH CHARLESTON, WV 25309

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is South Charleston Dermatology PLLC's NPI number?

The NPI number for South Charleston Dermatology PLLC is 1174604409. It was assigned to this organization in the NPPES registry on October 17, 2006.

Where is South Charleston Dermatology PLLC located?

South Charleston Dermatology PLLC is located at 4815 Kanawha Ave SW, South Charleston, WV 25309. The listed phone number is (304) 768-4567.

What is South Charleston Dermatology PLLC's specialty?

The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.

What insurance does South Charleston Dermatology PLLC accept?

Health plans from Highmark Blue Cross Blue Shield West Virginia list South Charleston Dermatology PLLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for South Charleston Dermatology PLLC was last updated on December 12, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.