LOWER CAPE FEAR DERMATOLOGY CLINIC, P.A.
NPI 1770509358
Specialist in Wilmington, NC

Active since July 15, 2006
3904 OLEANDER DR, SUITE 102, WILMINGTON, NC 28403(910) 452-0400(910) 452-0355 Get Directions Write a Review

NPPES record last updated: March 30, 2009. Verified against the NPPES registry weekly; last sync: July 19, 2026.

  • Organization
  • Specialist

About LOWER CAPE FEAR DERMATOLOGY CLINIC, P.A.

This page provides the complete NPI Profile along with additional information for Lower Cape Fear Dermatology Clinic, P.a., a provider established in Wilmington, North Carolina operating as a Specialist. The healthcare provider is registered in the NPI registry with number 1770509358 assigned on July 2006. The practitioner's primary taxonomy code is 174400000X with license number 103912 (NC). The provider is registered as an organization and their NPI record was last updated 17 years ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The authorized official of this NPI record is Mrs. Marylou Courrege M.d. (President/owner)

NPI
1770509358 Verify this NPI
Provider Name
LOWER CAPE FEAR DERMATOLOGY CLINIC, P.A.
Entity Type
Organization
Location Address
3904 OLEANDER DR SUITE 102 WILMINGTON, NC 28403
Location Phone
(910) 452-0400
Location Fax
(910) 452-0355
Mailing Address
3904 OLEANDER DR SUITE 102 WILMINGTON, NC 28403
Mailing Phone
(910) 452-0400
Mailing Fax
(910) 452-0355
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
07-15-2006
Last Update Date
03-30-2009
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Specialist

Taxonomy Code
174400000X
Type
Other Service Providers
License No.
103912
License State
NC
Taxonomy Description
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

Group Taxonomy 193400000X SINGLE SPECIALTY GROUP

This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

MRS. MARYLOU COURREGE M.D.

Authorized Official Title
PRESIDENT/OWNER
Authorized Official Phone
(910) 452-0400

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
2309918MEDICARE ID-TYPE UNSPECIFIED (04)NC 
D33065MEDICARE UPIN (02)NC 

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Other Providers at the Same Location


The following 16 providers are registered at the same or a nearby location.

Social Worker (Clinical)
3904 OLEANDER DR, SUITE 101
WILMINGTON, NC 28403
Social Worker (Clinical)
3904 OLEANDER DR, SUITE 101
WILMINGTON, NC 28403
Social Worker (Clinical)
3904 OLEANDER DR, SUITE 101
WILMINGTON, NC 28403
Behavior Technician
3904 OLEANDER DR, SUITE 102
WILMINGTON, NC 28403
Assistant Behavior Analyst
3904 OLEANDER DR
WILMINGTON, NC 28403
Behavior Technician
3904 OLEANDER DR, SUITE 102
WILMINGTON, NC 28403
Behavior Technician
3904 OLEANDER DR, #102
WILMINGTON, NC 28403
Behavior Technician
3904 OLEANDER DR, SUITE 102
WILMINGTON, NC 28403
Behavior Technician
3904 OLEANDER DR, SUITE 102
WILMINGTON, NC 28403
Physician Assistant
3904 OLEANDER DR
WILMINGTON, NC 28403
Dietitian, Registered
3904 OLEANDER DR
WILMINGTON, NC 28403
Social Worker (Clinical)
3904 OLEANDER DR
WILMINGTON, NC 28403
Family Medicine (Sports Medicine)
3904 OLEANDER DR
WILMINGTON, NC 28403
Clinic/Center (Mental Health (Including Community Mental Health Center))
3904 OLEANDER DR
WILMINGTON, NC 28403
Family Medicine (Sports Medicine)
3904 OLEANDER DR
WILMINGTON, NC 28403
Nurse Practitioner (Family)
3904 OLEANDER DR
WILMINGTON, NC 28403

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1770509358, enumerated as an "organization" on July 15, 2006.

The provider is located at 3904 OLEANDER DR SUITE 102 WILMINGTON, NC 28403 and the phone number is (910) 452-0400.

Specialist with taxonomy code 174400000X.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.