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SOUTHERN DERMATOLOGY CENTER, PC
NPI 1336172634
Dermatology in Decatur, AL

Active since July 09, 2006CLIA 01D0719700 · Certificate of Compliance
2828 HIGHWAY 31 S, SUITE 105, DECATUR, AL 35603(256) 351-9077(256) 351-0294 Get Directions Write a Review

NPPES record last updated: April 7, 2009. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Southern Dermatology Center, Pc NPPES

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

SOUTHERN DERMATOLOGY CENTER, PC (NPI 1336172634) is a healthcare organization registered as a dermatology in Decatur, Alabama and active in the NPI registry since July 2006. The organization holds a CLIA Certificate of Compliance certificate valid through July 5, 2027 and lists Angelo Mancuso, Owner, as its authorized official.

NPPES Registry Identity

NPI1336172634
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameSOUTHERN DERMATOLOGY CENTER, PC
Location Address2828 HIGHWAY 31 S, SUITE 105Decatur, AL 35603-1510
Mailing Address2828 Highway 31 S, Suite 105Decatur, AL 35603-1510 · (256) 351-9077 · Fax (256) 351-0294
Phone(256) 351-9077
Fax(256) 351-0294
Organization SubpartNo
Authorized OfficialAngelo MancusoOwner · (256) 351-9077
Enumeration DateJuly 9, 2006
Last NPPES UpdateApril 7, 2009
✔ NPI 1336172634 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207N00000X
License✔ Licensed in AL · D0196
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.
2828 HIGHWAY 31 S, Decatur, AL 35603
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Other Identifiers 3

Other051080875AL · Blue Cross Id#
Medicare UPIND80581AL
Medicare ID-Type Unspecified000080875AL

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

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Compliance 01D0719700

Southern Dermatology Center · Decatur, AL
Active · expires Jul 5, 2027
CLIA Number01D0719700
Laboratory TypePhysician Office
Certificate Effective DateJuly 6, 2025
Certificate Expiration DateJuly 5, 2027
Laboratory DirectorAngelo Mancuso
Laboratory Phone(256) 351-9996
Laboratory LocationSouthern Dermatology Center2828 Hwy 31 S Suite 105, Decatur, AL 35603
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Other Providers at the Same Location NPPES 20

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

DR. STEPHEN ALAN BRANNING M.D.
Internal Medicine
2828 HIGHWAY 31 S, SUITE 110
DECATUR, AL 35603
Morgan County (256) 350-9417
NRD MD LLC
Anesthesiology
2828 HIGHWAY 31 S
DECATUR, AL 35603
Morgan County (256) 350-4855
DR. RODNEY WAYNE HARNEY M.D.
Family Medicine
2828 HIGHWAY 31 S, SUITE 102
DECATUR, AL 35603
Morgan County (256) 351-9382
NEW LIFE FAMILY CHIROPRACTIC, PC
Chiropractor
2828 HIGHWAY 31 S, SUITE 104
DECATUR, AL 35603
Morgan County (256) 301-0110
DECATUR FAMILY PHARMACY
Pharmacy (Community/Retail Pharmacy)
2828 HIGHWAY 31 S
DECATUR, AL 35603
Morgan County (256) 822-2176
P J M REDDY MD
Internal Medicine
2828 HIGHWAY 31 S, SUITE 101
DECATUR, AL 35603
Morgan County (256) 309-5627
DIGESTIVE DISEASES ASSOCIATES
Internal Medicine (Gastroenterology)
2828 HIGHWAY 31 S
DECATUR, AL 35603
Morgan County (571) 221-0404
DEBRA BROWN PHILLIPS CRNP
Nurse Practitioner (Acute Care)
2828 HIGHWAY 31 S
DECATUR, AL 35603
Morgan County (256) 353-2000

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 Southern Dermatology Center, PC's NPI number?

The NPI number for Southern Dermatology Center, PC is 1336172634. It was assigned to this organization in the NPPES registry on July 9, 2006.

Where is Southern Dermatology Center, PC located?

Southern Dermatology Center, PC is located at 2828 Highway 31 S Suite 105, Decatur, AL 35603. The listed phone number is (256) 351-9077.

What is Southern Dermatology Center, PC's specialty?

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

Does Southern Dermatology Center, PC hold a CLIA laboratory certificate?

Yes. A Certificate of Compliance (number 01D0719700) is associated with this NPI, valid through July 5, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Southern Dermatology Center, PC was last updated on April 7, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 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.